Organization Active NPI

Linduc PC

Doing business as LINDUC Medical Clinic

  • Internal Medicine Physician
  • Decatur, GA
National Provider Identifier
1609162965
Registry record updated Mar 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
062127 Issued in GA
Legal business name
LINDUC PC
Doing business as
LINDUC Medical Clinic
Practice address
2680 Lawrenceville Hwy Ste 202
Decatur, GA 30033-2526
Phone
(470) 250-1418
Fax
(770) 674-7626
NPI assigned
Jun 24, 2011
Last updated
Mar 11, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2019

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

Authorized official

Name
Uchenna Peter Kalu, M.D.NPI 1841312907
Title
Medical Director
Phone
(470) 250-1418

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 062127 GA Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 062127 GA

Addresses

Primary practice location

2680 Lawrenceville Hwy Ste 202
Decatur, GA 30033-2526

Mailing address

2680 Lawrenceville Hwy Ste 202
Decatur, GA 30033-2526
Phone (470) 250-1418

Other names 1

  • LINDUC Medical Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110712000394 GA Part B Supplier - Clinic/Group Practice 6305014614 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
Practice locations: Decatur, GA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2154081Linduc Medical Clinic2680 Lawrenceville Highway, Decatur, GA 30033Certificate of waiverSep 5, 2026

National Provider Directory

National Provider Directory
Tax ID family
Linduc PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2680 Lawrenceville Hwy
Ste 202
Decatur, GA 30033
Phone (470) 250-1418

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1308873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552262400000",
    "number": "1609162965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2680 LAWRENCEVILLE HWY STE 202",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300332526",
            "telephone_number": "470-250-1418",
            "fax_number": "770-674-7626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2680 LAWRENCEVILLE HWY STE 202",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300332526",
            "telephone_number": "470-250-1418",
            "fax_number": "770-674-7626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINDUC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-24",
        "last_updated": "2019-03-11",
        "status": "A",
        "authorized_official_last_name": "KALU",
        "authorized_official_first_name": "UCHENNA",
        "authorized_official_middle_name": "PETER",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "470-250-1418",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "062127",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "GA",
            "license": "062127",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LINDUC Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.