KIDS & TEENS PRIMARY HEALTH CARE OF ATLANTA, P.C. (NPI# 1164432100) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164432100 |
| Entity Type | Organization |
| Organization Name | KIDS & TEENS PRIMARY HEALTH CARE OF ATLANTA, P.C. |
| Practice Address |
1462 Montreal Rd Ste 212 Tucker GA 30084-6929 |
| Practice Telephone | 4048754261 |
| Practice Fax Number | 7709397750 |
| Mailing Telephone | 4048754261 |
| Mailing Fax Number | 7709397750 |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. BYRON CEDRIC COTTON (OWNER/PHYSICIAN) |
| Authorized Official Telephone | 404-875-4261 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 208000000X | Pediatrics | 041098 | GA | Allopathic & Osteopathic Physicians |
| X | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
041098 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
1462 MONTREAL RD STE 212 |
| City | TUCKER |
| State | GA |
| Zip Code | 30084-6929 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194711093 | William C Tippins Jr. | Obstetrics & Gynecology | 1462 Montreal Rd, Suite 412, Tucker, GA 30084-6929 | 2005-09-26 |
| 1891243960 | Metro Community Healthcare LLC | Nurse Practitioner | 1462 Montreal Rd, Suite 418, Tucker, GA 30084-6932 | 2016-09-16 |
| 1093109795 | Medical Associates of Georgia | Internal Medicine | 1462 Montreal Rd, 307, Tucker, GA 30084-6929 | 2015-03-20 |
| 1205229192 | Advanced Orthopedic Surgery Center LLC | Clinic/Center | 1462 Montreal Rd, Suite 109, Tucker, GA 30084-6929 | 2015-03-17 |
| 1396085106 | Charlene Ann Morgan | Pharmacy Technician | 1462 Montreal Rd, Tucker, GA 30084 | 2013-02-15 |
| 1033458906 | Mark Monterola | Pharmacy Technician | 1462 Montreal Rd, Tucker, GA 30084-6929 | 2013-02-12 |
| 1477897288 | Amy Suzanne Duggan | Pharmacist | 1462 Montreal Rd, Tucker, GA 30084-6929 | 2012-11-16 |
| 1275809527 | Una Pharmacy Corporation | Pharmacy | 1462 Montreal Rd, Suite 101, Tucker, GA 30084-6929 | 2012-03-30 |
| 1316223514 | Una Pharmacy | Pharmacy | 1462 Montreal Rd, Ste 101, Tucker, GA 30084-6929 | 2011-11-01 |
| 1275840068 | Tucker Family Practice, L.L.C. | Family Medicine | 1462 Montreal Rd, Suite 307, Tucker, GA 30084-6929 | 2010-09-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609401355 | Excellent Medical Transport | Ambulance | 4378 Sentry Dr, Tucker, GA 30084 | 2020-03-03 |
| 1811468796 | Caleb Lee Ebbets | Physical Therapist | 1459 Montreal Road, Medical Office Building, Suite 301, Tucker, GA 30084 | 2018-12-17 |
| 1417436130 | Benjamin Han Wook Chong | Physical Therapist | 1460 Montreal Road East, Suite 300, Tucker, GA 30084 | 2018-08-13 |
| 1336659325 | Lavista Acupuncture and Herbal Medicine | Acupuncturist | 4915 Lavista Rd, Tucker, GA 30084 | 2017-10-04 |
| 1699294207 | Debrica Butler | Counselor | 1021 Oak Chase Dr., Apt C, Tucker, GA 30084 | 2017-09-14 |
| 1295264695 | Jolanta Wazgowska Hopkins | Social Worker | 4404 Idlewood Lane, Tucker, GA 30084 | 2017-06-08 |
| 1164956157 | Sage Dental Group of Georgia LLC | Dentist | 4320 Lavista Rd, Suite C119, Tucker, GA 30084 | 2017-04-17 |
| 1689107807 | Mashail Manzur | Podiatrist | 1460 Montreal Rd E, Ste 275, Tucker, GA 30084 | 2017-04-05 |
| 1053765578 | Jessica Spruyt | Speech-Language Pathologist | 3756 Lavista Rd Suite 104, Tucker, GA 30084 | 2016-04-21 |
| 1265802318 | Spine and Orthopedics of Atlanta, LLC | Clinic/Center | 1462 Montreal Rd Ste 218, Tucker, GA 30084 | 2015-10-01 |
| Find all providers in zip 30084 | ||||
| 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 |
|---|---|---|---|---|
| 1376829911 | Dekalb Pediatric Associates PC | Pediatrics | 1390 Montreal Rd Ste 180, Tucker, GA 30084-8187 | 2011-10-27 |
| 1508824392 | Athanasios Verras | Pediatrics | 2007 Montreal Rd, Tucker, GA 33084 | 2006-05-02 |
| 1326031741 | Jacqueline R Sulton | Pediatrics | 2258 Northlake Pkwy, Suite 100, Tucker, GA 30084-4019 | 2005-08-31 |
| 1396156238 | Zanna Reid | Pediatrics | 1918 Northlake Pkwy, Tucker, GA 30084-7070 | 2014-05-14 |
| 1881809937 | Verras Pediatrics PC | Pediatrics | 2181 Northlake Pkwy, Bldg 6 Suite 104, Tucker, GA 30084-4107 | 2007-05-11 |
| 1457438129 | Vickie Denese Jones | Pediatrics | 1918 Northlake Pkwy, Tucker, GA 30084-7070 | 2006-11-01 |
| 1457440596 | Sharon R Lehman | Pediatrics | 200 Crescent Centre Park, Pediatrics Health Care Team A, Tucker, GA 30084 | 2006-10-12 |
| 1467558189 | Betsy Cherian John | Pediatrics | 2007 Montreal Rd, Tucker, GA 30084 | 2006-09-16 |
| 1427151885 | Jon H Sudman | Pediatrics | 200 Crescent Centre Park, Pediatrics Health Care Team A, Tucker, GA 30084 | 2006-09-07 |
| 1215047212 | Herbert Alfred Singleton | Pediatrics | 200 Crescent Center Pkwy, Kp Crescent Center Medical Office, Tucker, GA 30084-7047 | 2006-08-30 |
| Find all providers in TUCKER | ||||
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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.