Eagles Landing Medical Center

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

EAGLES LANDING MEDICAL CENTER

Doing business as

Multi Specialist Practice

Practice address

1215 Eagles Landing Pkwy Ste 205
Stockbridge, GA 30281-7280

Phone

(770) 389-9116

NPI assigned

Dec 22, 2015

Organization subpart

No

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

Authorized official

Name

Sharon Selena Duncan

Title

Credentialing Specialist

Phone

(678) 656-7203

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• MULTI SPECIALIST PRACTICE Doing business as

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

{
    "created_epoch": "1450742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451952000000",
    "number": "1598120271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 EAGLES LANDING PKWY STE 205",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817280",
            "telephone_number": "770-389-9116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 EAGLES LANDING PKWY STE 205",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817280",
            "telephone_number": "770-389-9116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLES LANDING MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-22",
        "last_updated": "2016-01-05",
        "status": "A",
        "authorized_official_last_name": "DUNCAN",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "SELENA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "678-656-7203"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "GA",
            "license": "52394",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER",
            "identifier": "1144255399",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MULTI SPECIALIST PRACTICE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Eagle's Landing Pharmacy
• Eagle's Landing Pharmacy
• Eagle's Wings Healthcare Services, Inc.
• Eagles Landing Diabetes and Endocrinology (None)
• Eagles Landing Gastroenterology P.C.
• Eagles Landing Multi Speciality Group,LLC
• Eagles Landing Nephrology and Hypertension LLC
• Eagles Landing Pediatric Associates LLC
• Eagles Landing Surgery, P.C.
• James Van Eaton, MD

• Family Medicine Physician in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2016; 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.