Magnolia Comfort Medical South LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

MAGNOLIA COMFORT MEDICAL SOUTH LLC

Practice address

7193 Jonesboro Rd Ste 101-102
Morrow, GA 30260-2961

Phone

(470) 726-1699

NPI assigned

Apr 8, 2025

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kevin LeNPI 1851485775

Title

Clinic Director / Owner

Phone

(678) 268-8891

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tong Wang

  • Nurse Practitioner
  • Norcross, GA
  • NPI 1023899853
  Medicare reassignment NPD
• Kevin T Le, DC

  • Chiropractor
  • Peachtree Corners, GA
  • NPI 1851485775
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1744070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752192000000",
    "number": "1306630801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7193 JONESBORO RD STE 101-102",
            "city": "MORROW",
            "state": "GA",
            "postal_code": "302602961",
            "telephone_number": "470-726-1699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7193 JONESBORO RD STE 101-102",
            "city": "MORROW",
            "state": "GA",
            "postal_code": "302602961",
            "telephone_number": "470-726-1699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA COMFORT MEDICAL SOUTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-08",
        "last_updated": "2025-07-11",
        "certification_date": "2025-07-11",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "CLINIC DIRECTOR / OWNER",
        "authorized_official_telephone_number": "678-268-8891"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Luxottica of America Inc
• Luxottica of America Inc.
• Luxottica of America Inc.
• Sydoine Mahou, NURSE
• Vera Mahou, NP
• Bradley Mannone, PT
• Gabriella Eliese Maris, MD
• Mark Lynn OD & Associates PC

• Multi-Specialty Clinic/Center in Morrow, GA
• Providers in Morrow, GA by specialty
• Multi-Specialty Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.