TOTAL GRACE PEDIATRICS P.C. (NPI# 1396929444) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396929444 |
| Entity Type | Organization |
| Organization Name | TOTAL GRACE PEDIATRICS P.C. |
| Practice Address |
900 N Hairston Rd # Rs Suite A Stone Mountain GA 30083-2857 |
| Practice Telephone | 4042928103 |
| Practice Fax Number | 4042928105 |
| Mailing Telephone | 4042928103 |
| Mailing Fax Number | 4042928105 |
| Enumeration Date | 2007-12-26 |
| Last Update Date | 2007-12-26 |
| Authorized Official Name | DR. BASHIRU A DAWODU (PHYSICIAN) |
| Authorized Official Telephone | 4042928103 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
052162 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
900 N HAIRSTON RD # RS SUITE A |
| City | STONE MOUNTAIN |
| State | GA |
| Zip Code | 30083-2857 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558830919 | Patriot Healthcare of Georgia, LLC | Family Medicine | 833 Hairston Road, Stone Mountain, GA 30083 | 2018-11-15 |
| 1710403431 | Trans Med Ems,llc | Ambulance | 4683 Redan Rd, Stone Mountain, GA 30083 | 2017-08-15 |
| 1447770482 | Dispatched Angels Home Care | In Home Supportive Care | 619 El Prado Court, Stone Mountain, GA 30083 | 2017-06-21 |
| 1396191086 | Suzanne Carter | Chore Provider | 1036 Allgood Rd, Stone Mountain, GA 30083 | 2016-05-11 |
| 1437520087 | Meaza Dada | Pharmacist | 1043 Thornwoode Lane, Stone Mountain, GA 30083 | 2015-10-08 |
| 1427436500 | Raeanne Elizabeth Gialanella | Occupational Therapist | 5839 Memorial Drive, Stone Mountain, GA 30083 | 2015-05-11 |
| 1265829824 | Latore Williams | Licensed Practical Nurse | 5300 Ridge Forest Drive, Stone Mountain, GA 30083 | 2015-04-22 |
| 1144625922 | Granville Theodore Freeman IIi | Counselor | 5000 Brittany Drive, Stone Mountain, GA 30083 | 2014-10-23 |
| 1588974208 | Terri R Collins | Counselor | 1020 Strap Hinge Trail, Stone Mountain, GA 30083 | 2010-10-15 |
| 1104064815 | Vistas Medical Center,pc | Clinic/Center | 5329 Memorial Dr Ste A, Stone Mountain, GEORGIA 30083 | 2009-02-03 |
| Find all providers in zip 30083 | ||||
| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| 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) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093713356 | Edward Marvin Gotlieb | Pediatrics | 5405 Memorial Dr, Building D, Stone Mountain, GA 30083-3234 | 2005-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427616515 | Pedsnow LLC | Pediatrics | 863 W Oglethorpe Hwy Ste 220, Hinesville, GA 31313-4491 | 2019-06-03 |
| 1073885828 | Middle Georgia Pediatrics | Pediatrics | 1508 Hardeman Ave Ste B, Macon, GA 31201-1471 | 2012-02-08 |
| 1003184409 | Greer Gadsden Larned, M.d., P.C., Faap | Pediatrics | 3802 Waters Ave, Savannah, GA 31404-6210 | 2011-12-13 |
| 1427333095 | Dahlonega Pediatric and Adolescent Medicine | Pediatrics | 1055 North Grove St., Dahlonega, GA 30533 | 2011-10-14 |
| 1770710824 | Children's Medicine of Rockdale | Pediatrics | 1765 Parker Rd Se, Suite B210, Conyers, GA 30094-6652 | 2009-06-16 |
| 1518110451 | Pedia Doc Children's Med Ctr | Pediatrics | 3088 Campbellton Rd Sw, Atlanta, GA 30311-5410 | 2008-10-23 |
| 1306060801 | Crystal M Edds | Pediatrics | 125b Victory Dr, Swainsboro, GA 30401-3234 | 2007-04-13 |
| 1962523639 | William P Bristol | Pediatrics | 3300 Fourth Street, Brunswick, GA 31520-3779 | 2007-04-02 |
| 1861527103 | Florida Selga Basilio | Pediatrics | 1519 13th Ave, Columbus, GA 31901-1908 | 2007-02-23 |
| 1609902956 | Florida Basilio Md, PC | Pediatrics | 2039 Warm Springs Rd, Columbus, GA 31904-7931 | 2007-02-23 |
| Find all providers with the same taxonomy | ||||
| City | STONE MOUNTAIN |
| Zip Code | 30083 |
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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.