Northland Medical LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

NORTHLAND MEDICAL LLC

Practice address

270 Carpenter Dr Ste 515
Atlanta, GA 30328-4949

Phone

(404) 803-0573

NPI assigned

May 28, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Zachary David Lazarus, MDNPI 1902052772

Title

Co-Owner

Phone

(404) 709-2103

Specialties & licenses 1

Addresses

Other names 1

• ATLANTA KETAMINE CENTER Doing business as

Locations

Practitioners 1

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

• Zachary Lazarus, M.D.

  • Anesthesiology Physician
  • Atlanta, GA
  • NPI 1902052772
  NPD Authorized official

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

{
    "created_epoch": "1716854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716940800000",
    "number": "1689414757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 CARPENTER DR STE 515",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303284949",
            "telephone_number": "404-803-0573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 CARPENTER DR STE 515",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303284949",
            "telephone_number": "404-803-0573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHLAND MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-28",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-28",
        "status": "A",
        "authorized_official_last_name": "LAZARUS",
        "authorized_official_first_name": "ZACHARY",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "404-709-2103",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ATLANTA KETAMINE CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ATLANTA KETAMINE CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Northside Cardiology-Electrophysiology, LLC

• Mental Health Clinic/Center (Including Community Mental Health Center) in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; 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.