Active NPI
Oscar Dario Medina, M.D
- Psychiatry Physician
- Atlanta, GA
National Provider Identifier
1881751048
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 16105
- Practice address
- 2295 Park Lake Dr. N.E
4TH Floor Ste 468
Atlanta, GA 30345-2844 - Phone
- (770) 934-9307
- NPI assigned
- Jan 3, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 16105 | GA | Primary |
Addresses
Primary practice location
2295 Park Lake Dr. N.E
4TH Floor Ste 468
Atlanta, GA 30345-2844
Mailing address
2295 Park Lake Dr. N.E
4TH Floor Ste 468
Atlanta, GA 30345-2844
Phone (770) 934-9307
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16105 | GA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458777600000",
"number": "1881751048",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2295 PARK LAKE DR. N.E",
"address_2": "4TH FLOOR STE 468",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303452844",
"telephone_number": "770-934-9307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2295 PARK LAKE DR. N.E",
"address_2": "4TH FLOOR STE 468",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303452844",
"telephone_number": "770-934-9307"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDINA",
"first_name": "OSCAR",
"middle_name": "DARIO",
"name_prefix": "Dr.",
"credential": "M.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-03",
"last_updated": "2016-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "GA",
"license": "16105",
"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 Mar 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.