PEDIATRIC CARDIOLOGY SERVICES LLC (NPI# 1003077876) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003077876 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC CARDIOLOGY SERVICES LLC |
| Practice Address |
200 S Enota Dr Ne Suite 380 Gainesville GA 30501-3473 |
| Mailing Address |
500 Medical Center Blvd Suite 340 Lawrenceville GA 30045-8708 |
| Practice Telephone | 7709956684 |
| Practice Fax Number | 7709957631 |
| Mailing Telephone | 7709956684 |
| Mailing Fax Number | 7709957631 |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2008-06-24 |
| Authorized Official Name | MS. KIM WOODY (PRACTICE ADMINISTRATOR) |
| Authorized Official Telephone | 7709956684 |
| Authorized Official Credential | RMM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0202X |
Pediatrics Specialization: Pediatric Cardiology |
043298 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00740891A | 05 | |
| GA | 000326873G | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922269794 | Pediatric Cardiology Services LLC | Pediatrics | 980 Johnson Ferry Rd Ne, Suite 560, Atlanta, GA 30342-1626 | 2008-06-24 |
| 1467613232 | Pediatric Cardiology Services LLC | Pediatrics | 1380 Milstead Ave Ne, Suite J, Conyers, GA 30012-3864 | 2008-06-24 |
| Street Address |
200 S ENOTA DR NE SUITE 380 |
| City | GAINESVILLE |
| State | GA |
| Zip Code | 30501-3473 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972503837 | Gregory R Strauther | Surgery | 200 S Enota Dr Ne, Suite 150, Gainesville, GA 30501-3473 | 2005-07-21 |
| 1184158859 | April Mangum | Nurse Practitioner | 200 S Enota Dr Ne, Suite 200, Gainesville, GA 30501-3473 | 2017-04-19 |
| 1164962718 | Kendyl Burke | Physician Assistant | 200 S Enota Dr Ne, Suite 360, Gainesville, GA 30501-3473 | 2017-03-01 |
| 1740724814 | Jarred Ricketts | Physician Assistant | 200 S Enota Dr Ne, Suite 380, Gainesville, GA 30501-3473 | 2016-12-08 |
| 1538499058 | Anu Kumar Whisenhunt | Surgery | 200 S Enota Dr Ne, Suite 360, Gainesville, GA 30501-3473 | 2010-01-06 |
| 1780812974 | Robert Kyle Thompson | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 200 S Enota Dr Ne, Suite 380, Gainesville, GA 30501-3473 | 2009-06-25 |
| 1811165467 | Brandon Thomas Bruce | Orthopaedic Surgery | 200 S Enota Dr Ne, Suite 150, Gainesville, GA 30501-3473 | 2008-02-18 |
| 1124205562 | George A Ordway | Physician Assistant | 200 S Enota Dr Ne, Suite 200, Gainesville, GA 30501-3473 | 2008-01-29 |
| 1407031347 | James G Reeves | Surgery | 200 S Enota Dr Ne, Suite 360, Gainesville, GA 30501-3473 | 2008-01-09 |
| 1023293347 | Kelly Miller Lathem | Pediatrics | 200 S Enota Dr Ne, Suite 150, Gainesville, GA 30501-3473 | 2008-01-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437782851 | Madison Raye Huth | Physician Assistant | 743 Spring Street Se, Gainesville, GA 30501 | 2020-02-13 |
| 1205487659 | Grace M Walker Brown | Nurse Practitioner | 592 Medical Park Dr., Suite A, Gainesville, GA 30501 | 2019-09-26 |
| 1174086987 | Nayab Ahmed | Student in an Organized Health Care Education/Training Program | 743 Spring Street, Suite 710, Gainesville, GA 30501 | 2019-04-09 |
| 1154881118 | Ryan D Berry | Student in an Organized Health Care Education/Training Program | 734 Spring St Se Ste 710, Gainesville, GA 30501 | 2019-03-24 |
| 1609336304 | Harper E Niver | Student in an Organized Health Care Education/Training Program | 743 Spring St., Suite 710, Gainesville, GA 30501 | 2019-03-20 |
| 1508336173 | Bradee Burrell Aderholt | Nurse Practitioner | 663 Lanier Park Drive, Gainesville, GA 30501 | 2018-11-27 |
| 1578068359 | Soammy Liz Matias | Chiropractor | 961 Green Street, Gainesville, GA 30501 | 2018-03-26 |
| 1811496896 | Matthew Brown | Speech-Language Pathologist | 500 Spring St. Se Suite 101, Gainesville, GA 30501 | 2018-02-06 |
| 1346769825 | Dr. Skeete & Associates of North Georgia, P.C. | Optometrist | 150 Pearl Nix Parkway, Suite D3a, Gainesville, GA 30501 | 2017-09-15 |
| 1932624723 | M & B Imaging, PC | Radiology | 1640 Jesse Jewell Pkwy Se Ste 2, Gainesville, GA 30501 | 2017-08-14 |
| Find all providers in zip 30501 | ||||
| Taxonomy Code | 2080P0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Cardiology |
| A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134296296 | Biagio Pietra | Pediatrics | 1600 Sw Archer Rd # 100297, Gainesville, FL 32610-0297 | 2006-11-30 |
| 1366861908 | Laura Grace Wilson | Pediatrics | 1600 Sw Archer Rd, Gainesville, FL 32610-3049 | 2014-04-10 |
| 1912296773 | Dipankar Gupta | Pediatrics | 1600 Sw Archer Rd, Pediatric Critical Care Medicine Rm 10-504, Gainesville, FL 32610-3003 | 2011-04-01 |
| 1073724068 | Jennifer Go Co-vu | Pediatrics | 1600 Sw Archer Rd, Bader 202, Gainesville, FL 32610-3003 | 2007-05-24 |
| 1700804507 | Ira H Gessner | Pediatrics | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | 2006-07-18 |
| 1578507398 | Barry J Byrne | Pediatrics | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | 2006-06-15 |
| 1932146347 | Benjamin E Victorica | Pediatrics | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | 2006-06-02 |
| 1750360970 | Himesh Vijaykumar Vyas | Pediatrics | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | 2006-01-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679013452 | Baptist Specialty Physicians Inc | Pediatrics | 3301 N Oak St Ext, Valdosta, GA 31605 | 2017-02-28 |
| 1720408800 | Andrew Porter | Pediatrics | 202 Village Center Pkwy, Stockbridge, GA 30281-9044 | 2014-04-16 |
| 1689606782 | Albert Tuboku-metzger | Pediatrics | 202 Village Center Parkway, Stockbridge, GA 30281 | 2006-07-07 |
| 1992746929 | Deepti Singh | Pediatrics | 2069 Teron Trce, Suite 300, Dacula, GA 30019-1665 | 2006-06-09 |
| 1770521197 | Margaret J Strieper | Pediatrics | 1700 Tree Lane, Ste 330, Snellville, GA 30078 | 2006-06-04 |
| 1679523435 | Michael E Mcconnell | Pediatrics | 202 Village Ctr Parkway, Stockbridge, GA 30281 | 2006-05-11 |
| 1366491953 | Derek A Fyfe | Pediatrics | 1405 Clifton Rd, Atlanta, GA 30322 | 2006-05-09 |
| 1528017258 | William T Mahle | Pediatrics | 355 Tower Rd Ne Ste 204, Marietta, GA 30060-9413 | 2006-05-09 |
| 1548232036 | Lazaros K Kochilas | Pediatrics | 2835 Brandywine Road, Suite 300, Atlanta, GA 30341-5540 | 2006-02-07 |
| 1861485914 | Georgia Pediatric Cardiology | Pediatrics | 1045 Southcrest Dr, Ste 220, Stockbridge, GA 30281-6113 | 2005-08-24 |
| Find all providers with the same taxonomy | ||||
| City | GAINESVILLE |
| Zip Code | 30501 |
Please comment or provide details below to improve the information on PEDIATRIC CARDIOLOGY SERVICES LLC.
| 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.