Organization Active NPI

TSR Medical, LLC

  • Dermatology Physician
  • Palmetto, GA
National Provider Identifier
1831024298
Registry record updated Jun 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
TSR MEDICAL, LLC
Practice address
1263 Mado Loop Ste 100
Palmetto, GA 30268-2467
Phone
(470) 865-5827
NPI assigned
Jun 16, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2026

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

Authorized official

Name
Dr. Mary Alice Mina, MDNPI 1538329149
Title
Owner
Phone
(470) 865-5827

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

1263 Mado Loop Ste 100
Palmetto, GA 30268-2467

Mailing address

3225 McLeod Dr # 100
Las Vegas, NV 89121-2257
Phone (470) 865-5827

National Provider Directory

National Provider Directory

Locations

1263 Mado Loop
Ste 100
Palmetto, GA 30268

Practitioners & affiliated clinicians

Practitioners 1

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": "1781568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781568000000",
    "number": "1831024298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3225 MCLEOD DR # 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891212257",
            "telephone_number": "470-865-5827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1263 MADO LOOP STE 100",
            "city": "PALMETTO",
            "state": "GA",
            "postal_code": "302682467",
            "telephone_number": "470-865-5827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TSR MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-06-16",
        "last_updated": "2026-06-16",
        "certification_date": "2026-06-16",
        "status": "A",
        "authorized_official_last_name": "MINA",
        "authorized_official_first_name": "MARY ALICE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "470-865-5827",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmetto, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2026; 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.