Organization Active NPI

Metropolitan Atlanta OB/GYN

  • Gynecology Physician
  • Decatur, GA
National Provider Identifier
1356598833
Registry record updated Apr 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
Legal business name
METROPOLITAN ATLANTA OB/GYN
Practice address
4201 Rainbow Dr
Decatur, GA 30034-2302
Phone
(404) 534-0035
Fax
(404) 286-7100
NPI assigned
Aug 26, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2010

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

Authorized official

Name
Dr. Tyrone C. Malloy, M.D.NPI 1841393097
Title
Owner
Phone
(404) 534-0035

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
Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VG0400X Primary

Addresses

Primary practice location

4201 Rainbow Dr
Decatur, GA 30034-2302

Mailing address

4201 Rainbow Dr
Decatur, GA 30034-2302
Phone (404) 534-0035

Other identifiers 1

IdentifierTypeStateIssuer
000227741AMedicaidGA

National Provider Directory

National Provider Directory

Locations

4201 Rainbow Dr
Decatur, GA 30034
Phone (404) 534-0035

Practitioners & affiliated clinicians

Practitioners 1

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": "1219708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272326400000",
    "number": "1356598833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 RAINBOW DR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300342302",
            "telephone_number": "404-534-0035",
            "fax_number": "404-286-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 RAINBOW DR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300342302",
            "telephone_number": "404-534-0035",
            "fax_number": "404-286-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METROPOLITAN ATLANTA OB/GYN",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-26",
        "last_updated": "2010-04-27",
        "status": "A",
        "authorized_official_last_name": "MALLOY",
        "authorized_official_first_name": "TYRONE",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-534-0035",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000227741A",
            "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 Apr 27, 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.