Active NPI
Gastroenterology Medicine & Nutrition Clinic, PC
- Gastroenterology Physician
- Atlanta, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 021539
- Legal business name
- GASTROENTEROLOGY MEDICINE & NUTRITION CLINIC, PC
- Practice address
- 3886 Princeton Lakes Way SW Ste 120
Atlanta, GA 30331-5511 - Phone
- (404) 681-0000
- Fax
- (678) 866-2538
- NPI assigned
- Dec 11, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Edward A Layne, M.D.
- Title
- President
- Phone
- (404) 681-0000
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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 021539 | GA | Primary |
| Medical Specialty Clinic/Center | 261QM2500X | 021539 | GA |
Addresses
Primary practice location
3886 Princeton Lakes Way SW Ste 120
Atlanta, GA 30331-5511
Mailing address
PO Box 570744
Atlanta, GA 30357-3113
Phone (404) 681-0000
Other practice location 1
3200 Downwood Cir NW Ste 340
Atlanta, GA 30327-1605
Phone (404) 681-0000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00204586B | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D2336509 | Gastroenterology & Nutrition Clinics | Certificate of waiver | Jan 5, 2028 |
National Provider Directory
National Provider DirectoryLocations
3040 Highlands Pkwy SE
Ste C
Smyrna, GA 30082
Phone (404) 681-0000
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Gastroenterology Physician
- Atlanta, GA
- NPI 1891807434
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197331200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1749686400000",
"number": "1366625535",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 570744",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303573113",
"telephone_number": "404-681-0000",
"fax_number": "404-365-8354"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3886 PRINCETON LAKES WAY SW STE 120",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303315511",
"telephone_number": "404-681-0000",
"fax_number": "678-866-2538"
}
],
"practiceLocations": [
{
"address_1": "3200 Downwood Cir NW Ste 340",
"address_purpose": "LOCATION",
"city": "Atlanta",
"state": "GA",
"postal_code": "303271605",
"country_code": "US",
"telephone_number": "404-681-0000",
"fax_number": "404-365-8354",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "GASTROENTEROLOGY MEDICINE & NUTRITION CLINIC, PC",
"organizational_subpart": "NO",
"enumeration_date": "2007-12-11",
"last_updated": "2025-06-12",
"certification_date": "2025-06-12",
"status": "A",
"authorized_official_last_name": "LAYNE",
"authorized_official_first_name": "EDWARD",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "404-681-0000",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Gastroenterology",
"state": "GA",
"license": "021539",
"primary": true
},
{
"code": "261QM2500X",
"taxonomy_group": "",
"desc": "Clinic/Center, Medical Specialty",
"state": "GA",
"license": "021539",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00204586B",
"state": "GA"
}
],
"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 Jun 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.