South Atlanta Lung and Sleep Clinic Inc.

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

054405 Issued in GA

Legal business name

SOUTH ATLANTA LUNG AND SLEEP CLINIC INC.

Practice address

604A S 8TH St
Griffin, GA 30224-4214

Phone

(770) 227-1999

NPI assigned

Aug 29, 2007

Last updated

Jul 29, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Hari Gopal Madichetty, MDNPI 1437123585

Title

Owner

Phone

(770) 633-3843

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Hari Gopal Madichetty, MD, FCCP, D-ABSM

  • Specialist
  • Griffin, GA
  • NPI 1437123585
  Medicare reassignment Care Compare group NPD Authorized official
• John R Dupre, MD

  • Pulmonary Disease Physician
  • Griffin, GA
  • NPI 1043222649
  Medicare reassignment Care Compare group NPD
• Dominique L Bailey, FNP-C

  • Family Nurse Practitioner
  • Griffin, GA
  • NPI 1063903615
  Medicare reassignment NPD

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564358400000",
    "number": "1386838621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 326",
            "city": "LOCUST GROVE",
            "state": "GA",
            "postal_code": "302480326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604A S 8TH ST",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244214",
            "telephone_number": "770-227-1999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH ATLANTA LUNG AND SLEEP CLINIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-29",
        "last_updated": "2019-07-29",
        "status": "A",
        "authorized_official_last_name": "MADICHETTY",
        "authorized_official_first_name": "HARI",
        "authorized_official_middle_name": "GOPAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-633-3843",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "GA",
            "license": "054405",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "GA",
            "license": "054405",
            "primary": true
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "GA",
            "license": "054405",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "919846878A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shanice Smith
• Shanta Montraile Smith, CNA
• Tawni Marley Smith, CST
• William Valdon Smith
• Solutions to Thrive, LLC
• South Atlanta Radiology Associates- Griffin
• Southern Crescent Medical Services
• Southern Crescent Personal Care Home
• Southern Oral Surgery PC
• Southern Regional Medical Center Inc (Home Health)

• Pulmonary Disease Physician in Griffin, GA
• Providers in Griffin, GA by specialty
• Pulmonary Disease Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2019; 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.