Individual provider Active NPI

Edward Augustus Layne, M.D.

  • Gastroenterology Physician
  • Atlanta, GA
National Provider Identifier
1891807434
Registry record updated Jun 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
021539 Issued in GA
Practice address
3886 Princeton Lakes Way SW Ste 120
Atlanta, GA 30331-5511
Phone
(404) 681-0000
Fax
(678) 866-2538
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 021539 GA
Gastroenterology Physician 207RG0100X 021539 GA Primary

Addresses

Primary practice location

3886 Princeton Lakes Way SW Ste 120
Atlanta, GA 30331-5511

Mailing address

PO Box 570744
Atlanta, GA 30357-3113
Phone (404) 681-0000

Other practice location 1

3200 Downwood Cir NW
Suite 340
Atlanta, GA 30327-1610
Phone (404) 681-0000

Other identifiers 2

IdentifierTypeStateIssuer
00204586BMedicaidGA
021539OtherGALICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041018000467 GA Practitioner - GastroenterologyPractitioner - Internal Medicine 1951361575 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
021539GAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Anwan Wellness Medical Center PC Specialist CurrentSince Jul 1, 2008 Accepting new patients
Gastroenterology Medicine & Nutrition Clinic, PC Gastroenterology CurrentSince Mar 1, 2009 Accepting new patients
Atlanta Multi Specialty Group Past Accepting new patients

Locations

4514 Chamblee Dunwoody Rd
Ste 328
Atlanta, GA 30338

3200 Downwood Cir NW
Ste 340
Atlanta, GA 30327
Phone (404) 352-8156

3886 Princeton Lakes Way SW
Ste 120
Atlanta, GA 30331
Phone (302) 401-9193

725 N Central Ave
Hapeville, GA 30354
Phone (404) 761-2766

3969 S Cobb Dr SE
Ste 202
Smyrna, GA 30080
Phone (770) 432-5326

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BAGADD
  • FHIR API: https://api.platform.athenahealth.com/18041/brand/1/csg/1/fhir/r4

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749686400000",
    "number": "1891807434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 570744",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303573113",
            "telephone_number": "404-681-0000",
            "fax_number": "404-365-8354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3886 PRINCETON LAKES WAY SW STE 120",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303315511",
            "telephone_number": "404-681-0000",
            "fax_number": "678-866-2538"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3200 Downwood Cir NW",
            "address_2": "Suite 340",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303271610",
            "country_code": "US",
            "telephone_number": "404-681-0000",
            "fax_number": "404-365-8354",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAYNE",
        "first_name": "EDWARD",
        "middle_name": "AUGUSTUS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "021539",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "GA",
            "license": "021539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00204586B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "021539",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.