Atlanta South Gastroenterology P.C.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

ATLANTA SOUTH GASTROENTEROLOGY P.C.

Practice address

1136 Cleveland Ave
Suite 608
East Point, GA 30344-3618

Phone

(404) 763-1606

Fax

(404) 768-3505

NPI assigned

Jul 30, 2007

Last updated

Jul 30, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. David Michael Martin, M.D.

Title

President

Phone

(404) 763-1606

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Vickie H Browne, APRN

  • Adult Health Nurse Practitioner
  • Riverdale, GA
  • NPI 1982940797
  Medicare reassignment NPD
• Ralph Cornell Lyons, M.D.

  • Gastroenterology Physician
  • Riverdale, GA
  • NPI 1740379866
  Medicare reassignment NPD

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

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185753600000",
    "number": "1700076346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1136 CLEVELAND AVE",
            "address_2": "SUITE 608",
            "city": "EAST POINT",
            "state": "GA",
            "postal_code": "303443618",
            "telephone_number": "404-763-1606",
            "fax_number": "404-768-3505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1136 CLEVELAND AVE",
            "address_2": "SUITE 608",
            "city": "EAST POINT",
            "state": "GA",
            "postal_code": "303443618",
            "telephone_number": "404-763-1606",
            "fax_number": "404-768-3505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTA SOUTH GASTROENTEROLOGY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-30",
        "last_updated": "2007-07-30",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "404-763-1606",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Atlanta Medical Center, Inc. (Atlanta Medical Center- South Campus)
• Atlanta Medical Center, Inc. (Atlanta Medical Center- South Campus)
• Atlanta Medical Center, Inc. (Atlanta Medical Center- South Campus)
• Atlanta Minimally Invasive Surgical Assoc LLC
• Atlanta Obstetrics and Family Care, P.C.
• Atlanta South Nephrology,PC (Southeast Kidney Associates)
• Atlanta Structured Family Services
• Atlantic Med Supply
• Ba Group LLC
• Olufemi A Babalola, MD

• Gastroenterology Physician in East Point, GA
• Providers in East Point, GA by specialty
• Gastroenterology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2007; 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.