South Atlanta Integrative Medicine

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SOUTH ATLANTA INTEGRATIVE MEDICINE

Practice address

1240 Highway 54 W
Building 700, Suite 700
Fayetteville, GA 30214-4557

Phone

(404) 452-9931

NPI assigned

Jan 4, 2016

Organization subpart

No

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

Authorized official

Name

Lynn Stanley

Title

Authorized Official

Phone

(404) 452-9931

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/12474/brand/1/csg/1/fhir/r4

Practitioners 2

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

• Gina Gonzalez Johnson, D.O.

  • Family Medicine Physician
  • Fayetteville, GA
  • NPI 1790846210
  Medicare reassignment NPD
• Lisa Jan Merritt, NP

  • Family Nurse Practitioner
  • Fayetteville, GA
  • NPI 1386917995

  Family Medicine

  Medicare reassignment NPD

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

{
    "created_epoch": "1451865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451865600000",
    "number": "1760848980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 HIGHWAY 54 W",
            "address_2": "BUILDING 700, SUITE 700",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144557",
            "telephone_number": "404-452-9931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 HIGHWAY 54 W",
            "address_2": "BUILDING 700, SUITE 700",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144557",
            "telephone_number": "404-452-9931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH ATLANTA INTEGRATIVE MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-04",
        "last_updated": "2016-01-04",
        "status": "A",
        "authorized_official_last_name": "STANLEY",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "404-452-9931"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haiba Sonyika, M.D.
• Lourdes Soriano, SLP
• Source Medical Supplies
• South & East Medical Transport Group
• South Atlanta Ear Nose & Throat, PC
• South Atlanta Medical and Rehabilitation, LLC
• South Atlanta Spine and Wellness Center
• South Atlanta Surgical Assistants
• South Regional Surgical Services
• Southeast Georgia Injury Centers

• Family Medicine Physician in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2016; 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.