MYSTIC MEDICAL, LLC
NPI 1093108763
Podiatrist - Foot & Ankle Surgery in Atlanta, GA

Q: What is Mystic Medical, LLC's NPI number?

The NPI number for Mystic Medical, LLC is 1093108763. It was assigned to this organization in the NPPES registry on March 5, 2015.

Q: What is Mystic Medical, LLC's specialty?

The primary specialty registered for this NPI is Podiatrist, specializing in Foot & Ankle Surgery, with taxonomy code 213ES0103X.

Active since March 05, 2015

5555 GLENRIDGE CONNECTOR, SUITE 200, ATLANTA, GA 30342(404) 351-0055 Get Directions Write a Review

NPPES record last updated: March 25, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 25, 2025, Jan 12, 2016 (2 updates tracked since 2016).

On this page

About Mystic Medical, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MYSTIC MEDICAL, LLC (NPI 1093108763) is a healthcare organization registered as a foot & ankle surgery in Atlanta, Georgia and active in the NPI registry since March 2015. The organization lists Amanda Dykes, Admin, as its authorized official.

NPPES Registry Identity

NPI1093108763

Entity TypeOrganization

Primary Taxonomy213ES0103X

Legal Business NameMYSTIC MEDICAL, LLC

Location Address5555 GLENRIDGE CONNECTOR, SUITE 200Atlanta, GA 30342-4759

Mailing Address5555 Glenridge Connector, Suite 200Atlanta, GA 30342-4759

Phone(404) 351-0055

Organization SubpartNo

Authorized OfficialAmanda DykesAdmin · (404) 351-0055

Enumeration DateMarch 5, 2015

Last NPPES UpdateMarch 25, 20252 updates tracked since enumeration

NPPES CertifiedMarch 25, 2025

✔ NPI 1093108763 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPodiatrist · Foot & Ankle SurgeryPodiatric Medicine & Surgery Service Providers

Taxonomy Code213ES0103X

Also ListedOptometristTaxonomy 152W00000X

5555 GLENRIDGE CONNECTOR, Atlanta, GA 30342

Open in Google Maps ↗

Group Practice 2

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

UNIFIED WOMEN'S CARE OF GEORGIA 2, LLC

Obstetrics & Gynecology

5555 GLENRIDGE CONNECTOR, SUITE 200
ATLANTA, GA 30342

Fulton County (561) 300-2410

QUEVEDO HEALTH SERVICES CORP

Clinic/Center (Health Service)

5555 GLENRIDGE CONNECTOR, SUITE 200
ATLANTA, GA 30342

Fulton County (470) 424-4628

FULTON HEALTH SUPPLIES

Durable Medical Equipment & Medical Supplies

5555 GLENRIDGE CONNECTOR, SUITE 200
ATLANTA, GA 30342

Fulton County (470) 327-1635

ANKLE FOOT LEG CENTERS INC

Podiatrist (Foot & Ankle Surgery)

5555 GLENRIDGE CONNECTOR, 5555 GLENRIDGE CONNECTOR
ATLANTA, GA 30342

Fulton County (202) 276-9478

INNOVA HEALTHCARE LLC

Podiatrist

5555 GLENRIDGE CONNECTOR, STE. 200
ATLANTA, GA 30342

Fulton County (404) 351-0055

STG HEALTHCARE OF ATLANTA, INC

Hospice Care, Community Based

5555 GLENRIDGE CONNECTOR, SUITE 750
ATLANTA, GA 30342

Fulton County (404) 856-6110

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mystic Medical, LLC's NPI number?

The NPI number for Mystic Medical, LLC is 1093108763. It was assigned to this organization in the NPPES registry on March 5, 2015.

Where is Mystic Medical, LLC located?

Mystic Medical, LLC is located at 5555 Glenridge Connector Suite 200, Atlanta, GA 30342. The listed phone number is (404) 351-0055.

What is Mystic Medical, LLC's specialty?

The primary specialty registered for this NPI is Podiatrist, specializing in Foot & Ankle Surgery, with taxonomy code 213ES0103X.

What insurance does Mystic Medical, LLC accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Mystic Medical, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mystic Medical, LLC was last updated on March 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.