Omni Medical Group LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

OMNI MEDICAL GROUP LLC

Practice address

4153 Flat Shoals Pkwy Ste 300C
Decatur, GA 30034-4106

Phone

(404) 386-6510

Fax

(404) 500-2097

NPI assigned

Mar 18, 2021

Last updated

Apr 20, 2021By 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

Mr. Dylon Ross

Title

Manager

Phone

(678) 705-1308

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1616025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618876800000",
    "number": "1710563010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4153 FLAT SHOALS PKWY STE 300C",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300344106",
            "telephone_number": "404-386-6510",
            "fax_number": "404-500-2097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4153 FLAT SHOALS PKWY STE 300C",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300344106",
            "telephone_number": "404-386-6510",
            "fax_number": "404-500-2097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMNI MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-18",
        "last_updated": "2021-04-20",
        "certification_date": "2021-03-29",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "DYLON",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "678-705-1308",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Olney
• Lashayna Olojo, PHARMD
• David A. Olson, M.D.
• Omolara Ann Oluloro, MD, MPH
• Deslyn Ann Olunuga, MD
• Omni One Professional Counseling LLC
• Omolara Kuteyi MD, Inc
• Franklin Igbin Omorogbe, PMHNP
• Toluwalope Omosa
• Oms, LLC

• Internal Medicine Physician in Decatur, GA
• Providers in Decatur, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2021; 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.