Xyz Medical

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

26097 Issued in GA

Legal business name

XYZ MEDICAL

Practice address

9 Russell Dr Ste 201
Ellijay, GA 30540-5573

Phone

(706) 698-9679

Fax

(706) 698-9678

NPI assigned

Jun 26, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Robert W Lee, DC

Title

Owner

Phone

(706) 698-9679

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1529971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529971200000",
    "number": "1346735982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 RUSSELL DR STE 201",
            "city": "ELLIJAY",
            "state": "GA",
            "postal_code": "305405573",
            "telephone_number": "706-698-9679",
            "fax_number": "706-698-9678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 RUSSELL DR STE 201",
            "city": "ELLIJAY",
            "state": "GA",
            "postal_code": "305405573",
            "telephone_number": "706-698-9679",
            "fax_number": "706-698-9678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "XYZ MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-26",
        "last_updated": "2018-06-26",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-698-9679",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "GA",
            "license": "26097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carley Whitlow
• Willow Creek Adolescent Substance Abuse Program
• Willow Creek Substance Abuse Program
• Cassandra L Wilson, MD
• Judy Carol Wright
• Grayson York
• Suzanne Young, APRN, WHNP-BC
• Erica Allyne Zippel, DPT

• Physical Medicine & Rehabilitation Physician in Ellijay, GA
• Providers in Ellijay, GA by specialty
• Physical Medicine & Rehabilitation Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2018; 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.