NPIMap

Individual provider Active NPI

Igor Lacmanovic, M.D.

  • Hospitalist Physician
  • Canton, GA
National Provider Identifier
1891849352
Registry record updated Jan 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
059814 Issued in GA
Practice address
201 Hospital Rd
Canton, GA 30114-2408
Phone
(770) 720-5100
Fax
(404) 851-6325
NPI assigned
Jan 22, 2007
Last updated
Jan 19, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 045039 CT
Hospitalist Physician 208M00000X 059814 GA Primary

Addresses

Primary practice location

201 Hospital Rd
Canton, GA 30114-2408

Mailing address

201 Hospital Rd
Canton, GA 30114-2408
Phone (770) 720-5100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071012000065 GA Practitioner - HospitalistPractitioner - Internal Medicine 7618063215 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

1790 Mulkey Rd
Austell, GA 30106-1122

3950 Austell Rd
Austell, GA 30106-1121
Phone (770) 732-4022

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
045039CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Jan 12, 2015 Accepting new patients
North Atlanta Professional Services LLC Hospitalist CurrentSince Sep 1, 2013 Accepting new patients
Wellstar Medical Group, LLC Hospitalist CurrentSince Jan 12, 2015 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
24 On Physicians, P.C. Hospitalist CurrentSince Jan 20, 2009 Accepting new patients
24 On Physicians, PC Hospitalist CurrentSince Jan 20, 2009 Accepting new patients
Cobb Hospital, Inc Past Accepting new patients
Mount Lassen Emergency Physicians LLC Past Accepting new patients

Locations

13000 Deerfield Pkwy
Ste 100
Alpharetta, GA 30004

201 Hospital Rd
Canton, GA 30114
Phone (770) 479-1941

1412 Milstead Ave NE
Conyers, GA 30012
Phone (770) 918-3000

5150 Stilesboro Rd NW
Ste 120
Kennesaw, GA 30152
Phone (678) 354-0230

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

304 Turner McCall Blvd SW
Rome, GA 30165
Phone (706) 506-5000

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000

Interoperability endpoints

  • Direct secure messaging: ilacmanovic97027@directwellstar.org

Organizations & group practices 8

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484784000000",
    "number": "1891849352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 HOSPITAL RD",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301142408",
            "telephone_number": "770-720-5100",
            "fax_number": "404-851-6325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 HOSPITAL RD",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301142408",
            "telephone_number": "770-720-5100",
            "fax_number": "404-851-6325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACMANOVIC",
        "first_name": "IGOR",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2017-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "045039",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "GA",
            "license": "059814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

Verify at the official NPI Registry.