Magnolia Medical Group, LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

ME53031 Issued in GA

Legal business name

MAGNOLIA MEDICAL GROUP, LLC

Practice address

946 Harmony Rd
Eatonton, GA 31024-5877

Phone

(706) 991-5320

Fax

(866) 720-5313

NPI assigned

Aug 8, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Justin LanceNPI 1417258401

Title

Doctor/Owner

Phone

(478) 453-2341

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 3

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

• Gregory Daniel Bennett, MD

  • Internal Medicine Physician
  • Macon, GA
  • NPI 1366651507

  GA

  Medicare reassignment NPD
• Casey R. Black, NP

  • Nurse Practitioner
  • Stockbridge, GA
  • NPI 1003151028

  GA

  Medicare reassignment NPD
• Justin Andrew Lance, D.C.

  • Chiropractor
  • Eatonton, GA
  • NPI 1417258401
  NPD Authorized official

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

{
    "created_epoch": "1470614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726704000000",
    "number": "1801340856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "946 HARMONY RD STE B",
            "city": "EATONTON",
            "state": "GA",
            "postal_code": "310245877",
            "telephone_number": "706-991-5320",
            "fax_number": "866-720-5313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "946 HARMONY RD",
            "city": "EATONTON",
            "state": "GA",
            "postal_code": "310245877",
            "telephone_number": "706-991-5320",
            "fax_number": "866-720-5313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-08",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A",
        "authorized_official_last_name": "LANCE",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "478-453-2341",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "GA",
            "license": "ME53031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Ann Little, LDO
• Rulanda Mathis Little
• Donald Douglas Lowe, LAT, ATC
• Lucent Integrative Wellness
• Linda Marie M Cummings
• Marquesia Trion Mathis
• Kira Cheryle McCarthy, HOLISTIC
• Rebecca McMichael, RDMS
• Brooke McMillen, MED CCC-SLP
• Christa Michele McMillian, RN

• General Practice Physician in Eatonton, GA
• Providers in Eatonton, GA by specialty
• General Practice Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2024; 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.