FT MEDICAL GROUP, LLC (NPI# 1467072231) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467072231 |
| Entity Type | Organization |
| Organization Name | FT MEDICAL GROUP, LLC |
| Other Organization Name | ID-TECH MOLECULAR LABORATORIES |
| Practice Address |
777 Cleveland Ave Sw Ste 516 Atlanta GA 30315-7115 |
| Practice Telephone | 4049158877 |
| Mailing Telephone | 4042455543 |
| Enumeration Date | 2020-04-22 |
| Last Update Date | 2020-10-28 |
| Authorized Official Name | DARRYLE MAURICE FARRAR (CHIEF OPERATING OFFICER) |
| Authorized Official Telephone | 4042455543 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | Laboratories |
| Other Name | Type Code |
|---|---|
| ID-Tech Molecular Laboratories | Doing Business As Name - Organization |
| Street Address |
777 CLEVELAND AVE SW STE 516 |
| City | ATLANTA |
| State | GA |
| Zip Code | 30315-7115 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083181341 | Erin Cole | Specialist/Technologist | Lakewood Ave Se, Atlanta, GA 30315 | 2018-10-25 |
| 1942701081 | Julie Crocker | Dental Hygienist | 1046 Ridge Ave. Sw, Atlanta, GA 30315 | 2018-02-23 |
| 1457695850 | Dominica Aquino Morales-gibson | Physical Therapist | 2850 Springdale Road Sw, Atlanta, GA 30315 | 2012-11-26 |
| 1912264813 | Maxwell Uhakheme | Internal Medicine | 6875 Douglas Blvd, Suite A, Kaiser Permanente Douglasville Medical Center, Douglasville, GA 30315 | 2012-04-16 |
| 1427329093 | Sulonda Smith | Counselor | 34 Atlanta Ave. Se, Hank Aaron Blvd, Atlanta, GA 30315 | 2012-01-13 |
| 1407152507 | Gerald Leroy Griffin | Pharmacist | 520 Boulevard, Atlanta, GA 30315 | 2011-02-07 |
| 1245404854 | Tunisia Finch Cornelius | Dermatology | 1039 Grant St Se Ste A-11, Atlanta, GA 30315 | 2008-04-15 |
| 1356512180 | Chandra Blakely | Counselor | 215 Lakewood Way, Suite 205, Atlanta, GA 30315 | 2008-03-19 |
| 1104043967 | Alvin H. Clair, M.d.p.c. | Dermatology | 777 Cleveland Ave.,sw Ste.500, Atlanta, GA 30315 | 2007-04-20 |
| 1396877742 | Scott M Russell | Speech-Language Pathologist | 1364 Clifton Road, Atlanta, GA 30315 | 2007-03-12 |
| Find all providers in zip 30315 | ||||
| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033737382 | Community Health and Wellness Lab | Clinical Medical Laboratory | 1039 Ridge Ave Sw, Atlanta, GA 30315-1601 | 2020-07-13 |
| 1992344774 | Pulse Medical Diagnostic | Clinical Medical Laboratory | 2302 Parklake Dr Ne Ste 405, Atlanta, GA 30345-2896 | 2019-12-27 |
| 1285278846 | Reveal Diagnostic Services, Inc | Clinical Medical Laboratory | 3915 Cascade Rd Sw Ste 355, Atlanta, GA 30331-8520 | 2019-11-06 |
| 1679062103 | Sigma Labs, LLC | Clinical Medical Laboratory | 270 Carpenter Dr Ste 602, Atlanta, GA 30328-4931 | 2018-05-10 |
| 1588175194 | Beta Labs, LLC | Clinical Medical Laboratory | 270 Carpenter Dr Ste 600, Atlanta, GA 30328-4931 | 2017-10-23 |
| 1164962882 | Ipsum Diagnostics LLC | Clinical Medical Laboratory | 8607 Roberts Dr Ste 125, Atlanta, GA 30350 | 2017-02-28 |
| 1396297263 | Promed Testing, LLC | Clinical Medical Laboratory | 120 Valle Jo Ct, Atlanta, GA 30349-3644 | 2016-10-26 |
| 1659726487 | Pure Diagnostic, LLC | Clinical Medical Laboratory | 4025 Pleasantdale Rd Ste 525, Atlanta, GA 30340-4265 | 2016-04-29 |
| 1063892396 | Otogenetics Corporation | Clinical Medical Laboratory | 4553 Winters Chapel Rd Ste 100, Atlanta, GA 30360-2703 | 2015-06-02 |
| 1659781227 | Georgia Pathology | Clinical Medical Laboratory | 5335 Old National Hwy, Atlanta, GA 30349-3203 | 2014-05-05 |
| Find all providers in ATLANTA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.