NPIMap

Organization Active NPI

Thaddeus K Lynn, M.D., P.C.

  • Family Medicine Physician
  • Atlanta, GA
National Provider Identifier
1336492727
Registry record updated Apr 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
059670 Issued in GA
Legal business name
THADDEUS K LYNN, M.D., P.C.
Practice address
8495 Dunwoody PL
Building 9, Suite 100
Atlanta, GA 30350-3321
Phone
(770) 817-8423
Fax
(770) 817-8424
NPI assigned
Oct 23, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2015

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

Authorized official

Name
Dr. Thaddeus Kedron Lynn, M.D.NPI 1114182458
Title
Owner/Physician
Phone
(678) 773-7419

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 059670 GA Primary

Addresses

Primary practice location

8495 Dunwoody PL
Building 9, Suite 100
Atlanta, GA 30350-3321

Mailing address

8495 Dunwoody PL
Building 9, Suite 100
Atlanta, GA 30350-3321
Phone (770) 817-8423

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121119000193 GA Part B Supplier - Clinic/Group Practice 8628229762 Receives reassigned benefits from 1 practitioner
Practice locations: Atlanta, GA

National Provider Directory

National Provider Directory

Locations

8495 Dunwoody Pl
Ste 100
Sandy Springs, GA 30350
Phone (770) 817-8423

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1350950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430092800000",
    "number": "1336492727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8495 DUNWOODY PL",
            "address_2": "BUILDING 9, SUITE 100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303503321",
            "telephone_number": "770-817-8423",
            "fax_number": "770-817-8424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8495 DUNWOODY PL",
            "address_2": "BUILDING 9, SUITE 100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303503321",
            "telephone_number": "770-817-8423",
            "fax_number": "770-817-8424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THADDEUS K LYNN, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-23",
        "last_updated": "2015-04-27",
        "status": "A",
        "authorized_official_last_name": "LYNN",
        "authorized_official_first_name": "THADDEUS",
        "authorized_official_middle_name": "KEDRON",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "678-773-7419",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "059670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.