NPIMap

Organization Active NPI

Decatur Medical Group LLC

  • General Practice Physician
  • Marietta, GA
National Provider Identifier
1548459043
Registry record updated Oct 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
DECATUR MEDICAL GROUP LLC
Practice address
445 Windy Hill Rd SE # 222
Marietta, GA 30060-7342
Phone
(404) 284-2120
Fax
(404) 284-2126
NPI assigned
Oct 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2007

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

Authorized official

Name
Jean M Santana
Title
President/Owner
Phone
(404) 435-0663

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

445 Windy Hill Rd SE # 222
Marietta, GA 30060-7342

Mailing address

445 Windy Hill Rd SE # 222
Marietta, GA 30060-7342
Phone (404) 284-2120

National Provider Directory

National Provider Directory

Locations

445 Windy Hill Rd SE
Ste 222
Marietta, GA 30060
Phone (404) 284-2120

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1192838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192838400000",
    "number": "1548459043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 WINDY HILL RD SE # 222",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300607342",
            "telephone_number": "404-284-2120",
            "fax_number": "404-284-2126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 WINDY HILL RD SE # 222",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300607342",
            "telephone_number": "404-284-2120",
            "fax_number": "404-284-2126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DECATUR MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-20",
        "last_updated": "2007-10-20",
        "status": "A",
        "authorized_official_last_name": "SANTANA",
        "authorized_official_first_name": "JEAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "404-435-0663"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2007; 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.