NPIMap

Organization Active NPI

CCRM Atlanta, LLC

  • Clinical Medical Laboratory
  • Atlanta, GA
National Provider Identifier
1750752580
Registry record updated Jul 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
CCRM ATLANTA, LLC
Practice address
5909 Peachtree Dunwoody Rd
Suite 720
Atlanta, GA 30328-8102
Phone
(303) 908-9375
NPI assigned
Oct 20, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2026

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

Authorized official

Name
Matt Tyson
Title
Director, Managed Care Contracting
Phone
(615) 477-6677

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

5909 Peachtree Dunwoody Rd
Suite 720
Atlanta, GA 30328-8102

Mailing address

5909 Peachtree Dunwoody Rd Ste 600
Sandy Springs, GA 30328-8101
Phone (770) 928-2276

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D0973827CCRM Atlanta5909 Peachtree Dunwoody Road, Suite 600, Atlanta, GA 30328AccreditationJun 29, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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": "1445299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784592000000",
    "number": "1750752580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5909 PEACHTREE DUNWOODY RD STE 600",
            "city": "SANDY SPRINGS",
            "state": "GA",
            "postal_code": "303288101",
            "telephone_number": "770-928-2276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5909 PEACHTREE DUNWOODY RD",
            "address_2": "SUITE 720",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303288102",
            "telephone_number": "303-908-9375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCRM ATLANTA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-20",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A",
        "authorized_official_last_name": "TYSON",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "DIRECTOR, MANAGED CARE CONTRACTING",
        "authorized_official_telephone_number": "615-477-6677"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "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 Jul 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.