NPIMap

Organization Active NPI

Mark E. Crispin, M.D., P.C.

  • Plastic Surgery Physician
  • Atlanta, GA
National Provider Identifier
1689859274
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
032163 Issued in GA
Legal business name
MARK E. CRISPIN, M.D., P.C.
Practice address
5673 Peachtree Dunwoody Rd NE
Suite 100
Atlanta, GA 30342-1731
Phone
(404) 257-0064
Fax
(404) 257-1568
NPI assigned
Jan 2, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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

Authorized official

Name
Dr. Mark Elliston Crispin, M.D.
Title
Owner
Phone
(404) 257-0064

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X 032163 GA Primary

Addresses

Primary practice location

5673 Peachtree Dunwoody Rd NE
Suite 100
Atlanta, GA 30342-1731

Mailing address

5673 Peachtree Dunwoody Rd NE
Suite 100
Atlanta, GA 30342-1731
Phone (404) 257-9888

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1199232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654732800000",
    "number": "1689859274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5673 PEACHTREE DUNWOODY RD NE",
            "address_2": "SUITE 100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421731",
            "telephone_number": "404-257-9888",
            "fax_number": "404-257-1568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5673 PEACHTREE DUNWOODY RD NE",
            "address_2": "SUITE 100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421731",
            "telephone_number": "404-257-0064",
            "fax_number": "404-257-1568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK E. CRISPIN, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-02",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A",
        "authorized_official_last_name": "CRISPIN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ELLISTON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-257-0064",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "GA",
            "license": "032163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; 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.