Individual provider Active NPI

Lonnie C. Dalton, D.O.

  • Family Medicine Physician
  • Stone Mountain, GA
National Provider Identifier
1487804001
Registry record updated Sep 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
13368 Issued in GA
Practice address
6124 Kings Mountain CT
Stone Mountain, GA 30087-1920
Phone
(770) 923-1629
Fax
(770) 921-5626
NPI assigned
Sep 19, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 13368 GA Primary

Addresses

Primary practice location

6124 Kings Mountain CT
Stone Mountain, GA 30087-1920

Mailing address

6124 Kings Mountain CT
Stone Mountain, GA 30087-1920
Phone (770) 923-1629

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
13368GAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1221782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221782400000",
    "number": "1487804001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6124 KINGS MOUNTAIN CT",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300871920",
            "telephone_number": "770-923-1629",
            "fax_number": "770-921-5626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6124 KINGS MOUNTAIN CT",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300871920",
            "telephone_number": "770-923-1629",
            "fax_number": "770-921-5626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALTON",
        "first_name": "LONNIE",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-19",
        "last_updated": "2008-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "13368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stone Mountain, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2008; 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.