Mahon Family Medicine

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

43693 Issued in GA

Legal business name

MAHON FAMILY MEDICINE

Practice address

1786 Oak Rd
Suite B
Snellville, GA 30078-2220

Phone

(770) 925-2526

NPI assigned

Feb 21, 2013

Reactivated

Nov 28, 2022

Organization subpart

No

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

Authorized official

Name

Shelly L Harper, FNP-CNPI 1700438991

Title

Owner

Phone

(770) 925-2526

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 5

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

• Shelly Harper, FNP-C

  • Family Nurse Practitioner
  • Snellville, GA
  • NPI 1700438991
  Medicare reassignment Care Compare group Authorized official
• Scott T Keller, DO

  • Family Medicine Physician
  • Lilburn, GA
  • NPI 1609861830
  Medicare reassignment Care Compare group
• Jill Rae Mattingly, PA-C, MMSC

  • Physician Assistant
  • Tucker, GA
  • NPI 1770795361
  Medicare reassignment
• Thomas M Mahon Jr., O.D.

  • Optometrist
  • Snellville, GA
  • NPI 1619969169
  NPD
• Sabrena Patram, FNP

  • Family Nurse Practitioner
  • Snellville, GA
  • NPI 1417703281
  NPD

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

{
    "created_epoch": "1361404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707868800000",
    "number": "1629318035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1786 OAK RD",
            "address_2": "SUITE B",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782220",
            "telephone_number": "770-925-2526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1786 OAK RD",
            "address_2": "SUITE B",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782220",
            "telephone_number": "770-925-2526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAHON FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-21",
        "last_updated": "2024-02-14",
        "certification_date": "2023-10-17",
        "deactivation_date": "2022-09-19",
        "reactivation_date": "2022-11-28",
        "status": "A",
        "authorized_official_last_name": "HARPER",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-925-2526",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "43693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Macnamee
• Stanford James Maddox
• Mademind Wellness & Performance
• Wilfrido Matinezo Magat, M.D.
• Magz Health Services, Inc.
• Thomas M Mahon, MD
• Thomas M Mahon Jr., O.D.
• John Ryan Mahoney, DO
• Kimberly Ann Mainer, MS, OTR/L, CLT-LANA
• Seble Makonnen, PHARM.D

• Family Medicine Physician in Snellville, GA
• Providers in Snellville, 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 Feb 14, 2024; 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.