John Meddling, LCMT

Primary specialty

SpecialistTaxonomy code 174400000X

License

MT002021 Issued in GA

Practice address

5474 Oakley Industrial Blvd Apt 1032
Fairburn, GA 30213-4475

Phone

(678) 778-2109

Fax

(770) 774-4232

NPI assigned

Sep 18, 2014

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1410998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410998400000",
    "number": "1588066708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5474 OAKLEY INDUSTRIAL BLVD APT 1032",
            "city": "FAIRBURN",
            "state": "GA",
            "postal_code": "302134475",
            "telephone_number": "678-778-2109",
            "fax_number": "770-774-4232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5474 OAKLEY INDUSTRIAL BLVD APT 1032",
            "city": "FAIRBURN",
            "state": "GA",
            "postal_code": "302134475",
            "telephone_number": "678-778-2109",
            "fax_number": "770-774-4232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDDLING",
        "first_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "LCMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-18",
        "last_updated": "2014-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "MT002021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Fairburn, GA
• Providers in Fairburn, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2014; 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.