DR. GEOFFREY EDWARD MICKELLS (NPI# 1477796951) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477796951 |
| Entity Type | Individual |
| Full Name | DR. GEOFFREY EDWARD MICKELLS |
| Credential | M.D. |
| Practice Address |
5901-b Peachtree Dunwoody Rd Suite B-420 Atlanta GA 30328-7156 |
| Mailing Address |
1001 Johnson Fy Rd Ne Atlanta GA 30342-1605 |
| Practice Telephone | 4042529751 |
| Mailing Telephone | 4047855252 |
| Enumeration Date | 2009-04-13 |
| Last Update Date | 2018-04-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
01075563A | IN | Allopathic & Osteopathic Physicians |
| Y | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
074800 | GA | Allopathic & Osteopathic Physicians |
| N | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
036130375 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
5901-B PEACHTREE DUNWOODY RD SUITE B-420 |
| City | ATLANTA |
| State | GA |
| Zip Code | 30328-7156 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255655734 | Johnathan P Keenum | Pediatrics | 5901-b Peachtree Dunwoody Rd, Suite B-420, Atlanta, GA 30328 | 2010-03-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467910042 | Amber Andrews | Behavior Technician | 750 Hammond Drive Bldg 7 Suite 100, Atlanta, GA 30328 | 2019-03-04 |
| 1215492830 | Ryan William Dubinin | Behavior Technician | 750 Hammond Drive, Building 7, Suite 100, Atlanta, NJ 30328 | 2019-02-07 |
| 1346710142 | Emily Rose Lloyd Swavely | Speech-Language Pathologist | 5825 Glenridge Rd., Building 1, Suite 133, Atlanta, GA 30328 | 2018-12-05 |
| 1063994481 | Mark Edward Brachmanski | Optometrist | 800 Mount Vernon Highway Ne, Suite 130, Atlanta, GA 30328 | 2018-09-01 |
| 1407352578 | Nina Brown | Massage Therapist | 7100 Peachtree Dunwoody Rd Ste 110, Sandy Springs, GA 30328 | 2018-04-05 |
| 1336657741 | Renee Usher Reeves | Assistant Behavior Analyst | 750 Hammond Dr Building 7, Suite 100, Atlanta, GA 30328 | 2018-01-19 |
| 1487168274 | Patricia Nicole Felder | Student in an Organized Health Care Education/Training Program | 270 Carpenter Dr, Ne, Suite # 400, Atlanta, GA 30328 | 2017-12-01 |
| 1447762927 | Ponders Podiatry LLC | Podiatrist | 275 Carpenter Drive Ne, Suite 106, Atlanta, GA 30328 | 2017-10-24 |
| 1770093601 | Syed M Rasheed | Physician Assistant | 5788 Roswell Rd Ste 100, Atlanta, GA 30328 | 2017-10-05 |
| 1437678190 | Jeanette Denise Jones | Counselor | 270 Carpenter Drive, Suite 400, Sandy Springs, GA 30328 | 2017-09-13 |
| Find all providers in zip 30328 | ||||
| Taxonomy Code | 2080P0203X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Critical Care Medicine |
| A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275000358 | Spring Heather Ou-tim | Pediatrics | 5461 Meridian Marks Rd Ste 540, Atlanta, GA 30342-3283 | 2018-10-26 |
| 1225455793 | Lisa Lima | Pediatrics | 1405 Clifton Rd Ne, Atlanta, GA 30322-1020 | 2014-03-23 |
| 1265775159 | Neelima Krishnapriya Marupudi | Pediatrics | 1405 Clifton Rd Ne, Atlanta, GA 30322-1060 | 2013-03-29 |
| 1114215431 | Asaad G Beshish | Pediatrics | 1405 Clifton Rd Ne, Atlanta, GA 30322-5000 | 2011-07-20 |
| 1316238074 | Nabihah R Mahmood | Pediatrics | 980 Johnson Fy Rd Ne Ste 620, Atlanta, GA 30342-1608 | 2011-04-28 |
| 1033437215 | Brandon W Kirkland | Pediatrics | 1405 Clifton Rd Ne, Atlanta, GA 30322-1060 | 2010-05-12 |
| 1235371212 | Jocelyn Rebecca Grunwell | Pediatrics | 1405 Clifton Rd Ne, Choa Egleston, Tower 1, 4th Floor Ccm Offices, Atlanta, GA 30322-1059 | 2009-04-06 |
| 1659513224 | Amanda Ruth | Pediatrics | 1405 Clifton Rd Ne, Atlanta, GA 30322-1060 | 2009-03-29 |
| 1295992972 | Mary Lihinie Dealmeida | Pediatrics | 1405 Clifton Rd Ne, Atlanta, GA 30322-1060 | 2008-05-20 |
| 1881885531 | Treva Caraway Ingram | Pediatrics | 1405 Clifton Rd Ne, Atlanta, GA 30322-1060 | 2007-08-07 |
| Find all providers in ATLANTA | ||||
Please comment or provide details below to improve the information on DR. GEOFFREY EDWARD MICKELLS.
| 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.