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STANFORD MEDICAL GROUP, INC
NPI 1457521940
General Practice in Atlanta, GA

Active since March 11, 2008
142 MITCHELL ST SW, SUITE 200, ATLANTA, GA 30303(404) 584-2105(404) 584-2106 Get Directions Write a Review

NPPES record last updated: June 5, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Stanford Medical Group, Inc NPPES

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

STANFORD MEDICAL GROUP, INC (NPI 1457521940) is a healthcare organization registered as a general practice in Atlanta, Georgia and active in the NPI registry since March 2008. The organization lists Jeanette Junco Patino, Owner, as its authorized official.

NPPES Registry Identity

NPI1457521940
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameSTANFORD MEDICAL GROUP, INC
Location Address142 MITCHELL ST SW, SUITE 200Atlanta, GA 30303-3439
Mailing Address142 Mitchell St Sw, Suite 200Atlanta, GA 30303-3439 · (404) 584-2105 · Fax (404) 584-2106
Phone(404) 584-2105
Fax(404) 584-2106
Organization SubpartNo
Authorized OfficialJeanette Junco PatinoOwner · (786) 837-1175
Enumeration DateMarch 11, 2008
Last NPPES UpdateJune 5, 2008
✔ NPI 1457521940 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
Also ListedPhysical TherapistTaxonomy 225100000X
142 MITCHELL ST SW, Atlanta, GA 30303
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Other Identifiers 1

Medicare PIN511G700407GA

Group Practice 1

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

Other Providers at the Same Location NPPES 2

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

DR. ADEDAMOLA ONI MD
Internal Medicine
142 MITCHELL ST SW, LL1
ATLANTA, GA 30303
Fulton County (404) 688-2099
PHOENIX WELLNESS CENTER LLC
General Practice
142 MITCHELL ST SW, SUITE 200
ATLANTA, GA 30303
Fulton County (404) 584-2105

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 Stanford Medical Group, Inc's NPI number?

The NPI number for Stanford Medical Group, Inc is 1457521940. It was assigned to this organization in the NPPES registry on March 11, 2008.

Where is Stanford Medical Group, Inc located?

Stanford Medical Group, Inc is located at 142 Mitchell St SW Suite 200, Atlanta, GA 30303. The listed phone number is (404) 584-2105.

What is Stanford Medical Group, Inc's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

When was this NPI record last updated?

The NPPES record for Stanford Medical Group, Inc was last updated on June 5, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years 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.