Dartmouth Medical LLC

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

Legal business name

DARTMOUTH MEDICAL LLC

Practice address

2959 Sharpsburg McCullum Rd # 103
Newnan, GA 30265-2297

Phone

(617) 610-9339

NPI assigned

Nov 7, 2023

Organization subpart

No

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

Authorized official

Name

Jian Liang Pang, MDNPI 1558637058

Title

Ceo

Phone

(617) 610-9339

Specialties & licenses 2

Addresses

Other names 1

• Dartmouth Medical, LLC Other name

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.

• Jian Liang Pang, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Newnan, GA
  • NPI 1558637058

  Adult Medicine

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1699315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706140800000",
    "number": "1679347033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2959 SHARPSBURG MCCULLUM RD # 103",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302652297",
            "telephone_number": "770-202-1642",
            "fax_number": "770-202-1643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2959 SHARPSBURG MCCULLUM RD # 103",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302652297",
            "telephone_number": "617-610-9339"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6045 Atlantic Blvd Ste 106",
            "address_purpose": "LOCATION",
            "city": "Norcross",
            "state": "GA",
            "postal_code": "300711332",
            "country_code": "US",
            "telephone_number": "678-966-9886",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DARTMOUTH MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-07",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A",
        "authorized_official_last_name": "PANG",
        "authorized_official_first_name": "JIAN",
        "authorized_official_middle_name": "LIANG",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "617-610-9339",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dartmouth Medical, LLC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Dartmouth Medical, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Lela Daniell
• Kolisha Dee Daniels, NP
• Jacobie J Dardy
• Brittany Moore Darnell, CRNA
• Margaret Darracott
• Lauren Daugherty
• Karla Daum, COTA/L
• Lacey Daush, MA,CCC-SLP
• Elise G Davies, M.M.SC., P.A.-C
• Ann Marie Davis

• Endocrinology, Diabetes & Metabolism Physician in Newnan, GA
• Providers in Newnan, GA by specialty
• Endocrinology, Diabetes & Metabolism Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.