Magnolia Lane Plastic Surgery, LLC

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

Legal business name

MAGNOLIA LANE PLASTIC SURGERY, LLC

Practice address

3633 Wheeler Rd Ste 110
Augusta, GA 30909-6544

Phone

(706) 723-1632

Fax

(706) 869-3841

NPI assigned

Mar 6, 2024

Organization subpart

No

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

Authorized official

Name

Mrs. Taylor Cato

Title

Office Manager

Phone

(706) 723-1632

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

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

• Manuel Medina, M.D.

  • Plastic Surgery Physician
  • Augusta, GA
  • NPI 1558651935
  Medicare reassignment NPD

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

{
    "created_epoch": "1709683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724630400000",
    "number": "1659139590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 RONALD REAGAN DR UNIT 724",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308097729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3633 WHEELER RD STE 110",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309096544",
            "telephone_number": "706-723-1632",
            "fax_number": "706-869-3841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA LANE PLASTIC SURGERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-06",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A",
        "authorized_official_last_name": "CATO",
        "authorized_official_first_name": "TAYLOR",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "706-723-1632",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah W Magliolo, LOTR
• Magnolia Associates of Augusta
• Magnolia Bloom Behavior Solutions
• Magnolia Chiropractic Center, LLC
• Magnolia Family Chiropractic LLC
• Richard Magruder, M. D.
• Maguire & Moore Psyclological Services
• Maguire Therapy Services
• Maguire Therapy Services Inc.
• Maguire Therapy Services, Inc

• Plastic Surgery Physician in Augusta, GA
• Providers in Augusta, GA by specialty
• Plastic Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.