John Harrison Landrum, DO

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

16489 Issued in GA

Practice address

1120 15TH St # Bi5070
Augusta, GA 30912-0004

Phone

(706) 721-2423

NPI assigned

Apr 25, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• August University - Medical College of Georgia

  • Internal Medicine Physician
  • Augusta, GA
  • NPI 1730865619
  NPD

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

{
    "created_epoch": "1714003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1487400966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4290 SUGAR CREEK LN",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300412886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 15TH ST # BI5070",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120004",
            "telephone_number": "706-721-2423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDRUM",
        "first_name": "JOHN",
        "middle_name": "HARRISON",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-25",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "GA",
            "license": "16489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Talonda Landers
• Becca Trieu Landis, MD
• Debra Renee Landmann
• Regan Landoch
• Samuel Thomas Landoch, MD
• Joshua Alton Lane, M.D.
• Justin Lane
• Kellie V Lane, M.D.
• Lisa Ann Lane, RN
• Natalie Edith Lane, MD

• Student in an Organized Health Care Education/Training Program in Augusta, GA
• Providers in Augusta, GA by specialty
• Student in an Organized Health Care Education/Training Program in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.