Active NPI
Gary M Laskey, MD
- Diagnostic Radiology Physician
- Decatur, GA
National Provider Identifier
1336115203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 15788
- Practice address
- 2701 N Decatur Rd
Decatur, GA 30033-5918 - Phone
- (404) 564-5400
- Fax
- (404) 564-5403
- NPI assigned
- Feb 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 15788 | GA | Primary |
Addresses
Primary practice location
2701 N Decatur Rd
Decatur, GA 30033-5918
Mailing address
PO Box 1316
Indianapolis, IN 46206-1316
Phone (877) 440-0479
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000061289A | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15788 | GA | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371686400000",
"number": "1336115203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1316",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462061316",
"telephone_number": "877-440-0479"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2701 N DECATUR RD",
"city": "DECATUR",
"state": "GA",
"postal_code": "300335918",
"telephone_number": "404-564-5400",
"fax_number": "404-564-5403"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LASKEY",
"first_name": "GARY",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-28",
"last_updated": "2013-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "GA",
"license": "15788",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000061289A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Decatur, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.