1. Home
  2. Directory
  3. Georgia
  4. Fayetteville
  5. Family Medicine
  6. NPI Profile

SOUTH ATLANTA INTEGRATIVE MEDICINE
NPI 1760848980
Family Medicine in Fayetteville, GA

Active since January 04, 2016CLIA 11D2112333 · Waiver
1240 HIGHWAY 54 W, BUILDING 700, SUITE 700, FAYETTEVILLE, GA 30214(404) 452-9931 Get Directions Write a Review

NPPES record last updated: January 4, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About South Atlanta Integrative Medicine NPPES

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

SOUTH ATLANTA INTEGRATIVE MEDICINE (NPI 1760848980) is a healthcare organization registered as a family medicine in Fayetteville, Georgia and active in the NPI registry since January 2016. The organization holds a CLIA Waiver certificate valid through April 26, 2028 and lists Lynn Stanley, Authorized Official, as its authorized official.

NPPES Registry Identity

NPI1760848980
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSOUTH ATLANTA INTEGRATIVE MEDICINE
Location Address1240 HIGHWAY 54 W, BUILDING 700, SUITE 700Fayetteville, GA 30214-4557
Mailing Address1240 Highway 54 W, Building 700, Suite 700Fayetteville, GA 30214-4557 · (404) 452-9931
Phone(404) 452-9931
Organization SubpartNo
Authorized OfficialLynn StanleyAuthorized Official · (404) 452-9931
Enumeration DateJanuary 4, 2016
✔ NPI 1760848980 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1240 HIGHWAY 54 W, Fayetteville, GA 30214
Open in Google Maps ↗

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D2112333

South Atlanta Intergrative Medicine, LLC · Fayetteville, GA
Active · expires Apr 26, 2028
CLIA Number11D2112333
Laboratory TypePhysician Office
Certificate Effective DateApril 27, 2026
Certificate Expiration DateApril 26, 2028
Laboratory DirectorDr. Gina A. Gonzalez Johnson
Laboratory Phone(770) 703-4790
Laboratory LocationSouth Atlanta Intergrative Medicine, LLC1240 Hwy 54 West Buildin, Fayetteville, GA 30214
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 11

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

CB & NIKKY INC
Pharmacy (Community/Retail Pharmacy)
1240 HIGHWAY 54 W, BLDG 100,STE101
FAYETTEVILLE, GA 30214
Fayette County (770) 719-9050
HEARING AID SERVICES OF ATLANTA, LLC
Hearing Instrument Specialist
1240 HIGHWAY 54 W, STE. 604
FAYETTEVILLE, GA 30214
Fayette County (770) 461-7002
MEDALERT,LLC
Clinical Medical Laboratory
1240 HIGHWAY 54 W, SUITE 102
FAYETTEVILLE, GA 30214
Fayette County (770) 892-1821
MRS. LISA JAN MERRITT NP
Nurse Practitioner (Family)
1240 HIGHWAY 54 W, BUILDING 700, SUITE 700
FAYETTEVILLE, GA 30214
Fayette County (404) 452-9931
AMEDISYS GEORGIA LLC
Home Health
1240 HIGHWAY 54 W, SUITE 601 BLDG. 600
FAYETTEVILLE, GA 30214
Fayette County (770) 719-9155
FANG HELEN YU NURSE PRACTITIONER
Nurse Practitioner
1240 HIGHWAY 54 W, BUILDING 300, SUITE 310
FAYETTEVILLE, GA 30214
Fayette County (770) 461-6400
MRS. GINA GONZALEZ JOHNSON D.O.
Family Medicine
1240 HIGHWAY 54 W, BUILDING 700, SUITE 700
FAYETTEVILLE, GA 30214
Fayette County (404) 452-9931
PREMIER MEDICAL SUPPLY
Durable Medical Equipment & Medical Supplies
1240 HIGHWAY 54 W, SUITE 504
FAYETTEVILLE, GA 30214
Fayette County (770) 731-1935

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 South Atlanta Integrative Medicine's NPI number?

The NPI number for South Atlanta Integrative Medicine is 1760848980. It was assigned to this organization in the NPPES registry on January 4, 2016.

Where is South Atlanta Integrative Medicine located?

South Atlanta Integrative Medicine is located at 1240 Highway 54 W Building 700, Suite 700, Fayetteville, GA 30214. The listed phone number is (404) 452-9931.

What is South Atlanta Integrative Medicine's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does South Atlanta Integrative Medicine hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2112333) is associated with this NPI, valid through April 26, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for South Atlanta Integrative Medicine was last updated on January 4, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.