Smokerise Family Medical Assoc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0033273 Issued in GA

Legal business name

SMOKERISE FAMILY MEDICAL ASSOC

Practice address

1505 Lilburn Stone Mountain Rd
Ste 100
Stone Mountain, GA 30087-1857

Phone

(770) 469-1711

Fax

(770) 469-1837

NPI assigned

Dec 3, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Michael Lesley Baron, D.O.

Title

Family Physician/President

Phone

(770) 469-1711

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1291334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291334400000",
    "number": "1326340829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 LILBURN STONE MOUNTAIN RD",
            "address_2": "STE 100",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300871857",
            "telephone_number": "770-469-1711",
            "fax_number": "770-469-1837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 LILBURN STONE MOUNTAIN RD",
            "address_2": "STE 100",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300871857",
            "telephone_number": "770-469-1711",
            "fax_number": "770-469-1837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMOKERISE FAMILY MEDICAL ASSOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-03",
        "last_updated": "2010-12-03",
        "status": "A",
        "authorized_official_last_name": "BARON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "LESLEY",
        "authorized_official_title_or_position": "FAMILY PHYSICIAN/PRESIDENT",
        "authorized_official_telephone_number": "770-469-1711",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "0033273",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00474779A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Stone Mountain, GA
• Providers in Stone Mountain, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.