Organization Active NPI

Three in One Medical

  • Preferred Provider Organization
  • Lilburn, GA
National Provider Identifier
1659818482
Registry record updated Jan 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
License
305R0000X Issued in GA
Legal business name
THREE IN ONE MEDICAL
Practice address
5222 Addison TRL SW
Lilburn, GA 30047-6670
Phone
(404) 396-3997
NPI assigned
Jan 31, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2017

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

Authorized official

Name
Ms. Stephane Maurisha Lang, MD
Title
Physician
Phone
(404) 396-3997

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preferred Provider Organization 305R00000X 305R0000X GA Primary

Addresses

Primary practice location

5222 Addison TRL SW
Lilburn, GA 30047-6670

Mailing address

5222 Addison TRL SW
Lilburn, GA 30047-6670
Phone (404) 396-3997

Other identifiers 1

IdentifierTypeStateIssuer
11065411022MedicaidGA

National Provider Directory

National Provider Directory
Tax ID family
Three in One Medical2 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.

NPI Registry JSON

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

{
    "created_epoch": "1485820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485820800000",
    "number": "1659818482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5222 ADDISON TRL SW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300476670",
            "telephone_number": "404-396-3997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5222 ADDISON TRL SW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300476670",
            "telephone_number": "404-396-3997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THREE IN ONE MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-31",
        "last_updated": "2017-01-31",
        "status": "A",
        "authorized_official_last_name": "LANG",
        "authorized_official_first_name": "STEPHANE",
        "authorized_official_middle_name": "MAURISHA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "404-396-3997",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "GA",
            "license": "305R0000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11065411022",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lilburn, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2017; 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.