Ft Medical Group, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

FT MEDICAL GROUP, LLC

Practice address

777 Cleveland Ave SW Ste 516
Atlanta, GA 30315-7115

Phone

(404) 915-8877

NPI assigned

Apr 22, 2020

Organization subpart

No

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

Authorized official

Name

Darryle Maurice Farrar

Title

Chief Operating Officer

Phone

(404) 245-5543

Specialties & licenses 1

Addresses

Other names 1

• ID-Tech Molecular Laboratories Doing business as

Electronic endpoints 2

Locations

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

{
    "created_epoch": "1587513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603843200000",
    "number": "1467072231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 CLEVELAND AVE SW STE 516",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303157115",
            "telephone_number": "404-245-5543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 CLEVELAND AVE SW STE 516",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303157115",
            "telephone_number": "404-915-8877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FT MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-22",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A",
        "authorized_official_last_name": "FARRAR",
        "authorized_official_first_name": "DARRYLE",
        "authorized_official_middle_name": "MAURICE",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "404-245-5543"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "darryle@utimanagement.com",
            "affiliation": "N",
            "endpointDescription": "secure email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "777 Cleveland Ave SW Ste 516",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303157115",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "darryle@idtechmolecular.com",
            "affiliation": "N",
            "endpointDescription": "secure email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "777 Cleveland Ave SW Ste 516",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303157115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "ID-Tech Molecular Laboratories",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ID-Tech Molecular Laboratories",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jazmine Quyantranae Frye, AGACNP
• Leigh Ann Frye, PA-C
• Robert M Fryer, DDS
• Sandra Adamson Fryhofer, MD
• FS Partners Investments Inc
• Robert Fu
• Theresa Fu
• Weibo Fu, MD
• Meredith Davis Fuchs
• Andrea Fuentes-Dominguez

• Clinical Medical Laboratory in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Clinical Medical Laboratory in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; 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.