Three in One Medical

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

305R00000X Issued in GA

Legal business name

THREE IN ONE MEDICAL

Practice address

5222 Addison TRL SW
Lilburn, GA 30047-6670

Phone

(770) 282-9860

NPI assigned

Feb 13, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Stanley Earl Jacobs, MD

Title

Owner

Phone

(770) 282-9860

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Three in One Medical2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Three in One Medical

  • Preferred Provider Organization
  • Lilburn, GA
  • NPI 1659818482
  NPD tax ID

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

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486944000000",
    "number": "1821537655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5222 ADDISON TRL SW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300476670",
            "telephone_number": "770-282-9860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5222 ADDISON TRL SW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300476670",
            "telephone_number": "770-282-9860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THREE IN ONE MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-13",
        "last_updated": "2017-02-13",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "STANLEY",
        "authorized_official_middle_name": "EARL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-282-9860",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "GA",
            "license": "305R00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111564508489",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas Eye Group PC
• Asha Athyal Thomas, PHARMD
• Kierra Monique Thomas
• Sheela Thomas
• Three in One Medical
• Thrive Nutrition, LLC
• Through Thick & Thin Perinatal Services, LLC
• Thryvmed Solutions LLC
• Lissette E. Tirado, D.P.M.
• Einat Toledano

• Preferred Provider Organization in Lilburn, GA
• Providers in Lilburn, GA by specialty
• Preferred Provider Organization in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2017; 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.