Kenneth J Lazarus, MD,PHD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

031058 Issued in GA

Practice address

1250 Highway 54 W
Ste. 102
Fayetteville, GA 30214-4545

Phone

(770) 719-2965

Fax

(770) 719-2963

NPI assigned

Jun 29, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pathlink of Georgia LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Riverdale, GA
  • NPI 1831890169
  NPD
• American Health Imaging of Georgia, LLC

  • Radiology Clinic/Center
  • Atlanta, GA
  • NPI 1891151064
  NPD (past)
• Medica Stand-Up MRI, LLC

  • Radiology Clinic/Center
  • Atlanta, GA
  • NPI 1801834551
  NPD (past)
• North Atlanta Scan Associates Inc

  • Radiology Clinic/Center
  • Alpharetta, GA
  • NPI 1700826096
  NPD (past)
• Southern Regional Health System, Inc

  • General Acute Care Hospital
  • Riverdale, GA
  • NPI 1831190958
  NPD (past)

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328486400000",
    "number": "1689602385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 HIGHWAY 54 W",
            "address_2": "STE. 102",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144545",
            "telephone_number": "770-719-2965",
            "fax_number": "770-719-2963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 HIGHWAY 54 W",
            "address_2": "STE. 102",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144545",
            "telephone_number": "770-719-2965",
            "fax_number": "770-719-2963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZARUS",
        "first_name": "KENNETH",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD,PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2012-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "GA",
            "license": "031058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000406975D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barbara F. Law, CRNA
• Anthony F Lawson, MD
• Kathryn Lawson, PHD
• Layne Center for Therapy, Education, and Assessment
• Jessica Claire Layson
• Gary Bruce Lebendiger, MD
• Rachel Lynn Lee Jackman, LPC
• Ashley T Lee, RD, LD
• Dave Childress Lee, D.M.D.
• Jacob Lee, DMD, MD

• Neurology Physician in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Neurology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2012; 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.