DECATUR PEDIATRICS GROUP - COVINGTON (NPI# 1093143810) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093143810 |
| Entity Type | Organization |
| Organization Name | DECATUR PEDIATRICS GROUP - COVINGTON |
| Practice Address |
10246 Industrial Blvd Ne Covington GA 30014-1476 |
| Practice Telephone | 4042967133 |
| Mailing Telephone | 4042967133 |
| Enumeration Date | 2013-10-15 |
| Last Update Date | 2013-10-15 |
| Authorized Official Name | LYNETTE WILSON-PHILLIPS (PHYSICIAN/MANAGER) |
| Authorized Official Telephone | 4042967133 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| Street Address |
10246 INDUSTRIAL BLVD NE |
| City | COVINGTON |
| State | GA |
| Zip Code | 30014-1476 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801495635 | Cathy Cassandra Collins | Pharmacist | 3639 Hwy 278, Covington, GA 30014 | 2020-10-22 |
| 1154933877 | Atl Optical LLC | Optometrist | 3135 Highway 278 Ne, Covington, GA 30014 | 2020-08-24 |
| 1932737046 | Samagas House Org | Adult Companion | 1500 Mountain View Cirlcle, Conyers, GA 30014 | 2020-04-01 |
| 1356834360 | Covington Dental Care | Dentist | 4139 Baker Street, Suite 15, Covington, GA 30014 | 2018-06-13 |
| 1487190005 | New Avenues Assessment and Counseling Center LLC | Counselor | 3192 Spring Street, Covington, NEWTON 30014 | 2017-01-07 |
| 1275903973 | Jennifer Carol Bridges | Registered Nurse | 320 Malcom Lane, Covington, GA 30014 | 2015-10-07 |
| 1134598501 | Shelby Boggus King | Physician Assistant | 4181 Hospital Drive Ne, Suite 204, Covington, GA 30014 | 2015-09-16 |
| 1366829814 | Wendy Pazdur | Counselor | 5109 Hwy 278 East, Suite D, Covington, GA 30014 | 2015-05-05 |
| 1306235445 | Covington Center for Family Dentistry | Dentist | 10373 Industrial Blvd, Covington, GA 30014 | 2015-01-13 |
| 1992103428 | Modern Cosmetic Dental Care, LLC | Clinic/Center | 1750 Highway 11, Suite B, Covington, GA 30014 | 2014-12-16 |
| Find all providers in zip 30014 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| 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/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447541321 | Nancy O'neil Carter | Pediatrics | 11 Dogwood Ln, Covington, LA 70435-9526 | 2011-04-26 |
| 1538329370 | Amar Harshad Dave | Pediatrics | 751 Mirabella Ln, Covington, LA 70433-0882 | 2008-06-16 |
| 1578743811 | Jill Aileen Fitzpatrick | Pediatrics | 101 Judge Tanner Blvd., #302, Covington, LA 70433-7506 | 2007-11-03 |
| 1417094244 | Elizabeth B White Md Inc | Pediatrics | 205 Highland Park Plz, Covington, LA 70433-7130 | 2007-01-31 |
| 1487703153 | Candra Lanette Mack | Pediatrics | 4152 Baker Street, Ne, Covington, GA 30014-1404 | 2007-01-10 |
| 1245308311 | Carlos M Vides Jr. | Pediatrics | 4405 Highway 190 East Service Rd, Covington, LA 70433-4957 | 2006-11-30 |
| 1922012269 | Ghazala Khalid | Pediatrics | 7138 Highway 212, C, Covington, GA 30016-8047 | 2006-07-29 |
| 1245275809 | Fairway Pediatrics LLC | Pediatrics | 7020 Highway 190, Suite C, Covington, LA 70433-4954 | 2006-06-18 |
| 1881645174 | Cheryl A Manning | Pediatrics | 4106 Mill St Ne, Covington, GA 30014-2539 | 2006-05-12 |
| 1487605895 | Juliana N Nahas | Pediatrics | 4181 Hospital Dr, Ste 202, Covington, GA 30014 | 2006-05-12 |
| Find all providers in COVINGTON | ||||
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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.