PEBE MED, INC (NPI# 1568766293) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568766293 |
| Entity Type | Organization |
| Organization Name | PEBE MED, INC |
| Other Organization Name | CHILDREN FIRST PEDIATRIC CLINIC |
| Practice Address |
1267 Interstate Pkwy Augusta GA 30909-6481 |
| Mailing Address |
786 Locks Way Martinez GA 30907-4976 |
| Practice Telephone | 7068680919 |
| Practice Fax Number | 7068680929 |
| Mailing Telephone | (706) 231-5977 |
| Mailing Fax Number | 7068680929 |
| Enumeration Date | 2011-01-10 |
| Last Update Date | 2017-08-07 |
| Authorized Official Name | MR. ROSALITO C CRUZ (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 7062315977 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
051131 | GA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000940354E | 05 |
| Other Name | Type Code |
|---|---|
| Children First Pediatric Clinic | Doing Business As Name - Organization |
| Street Address |
1267 INTERSTATE PKWY |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30909-6481 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326237520 | Larry H Pierce Md PC | Dermatology | 1267 Interstate Pkwy, Augusta, GA 30909-6481 | 2007-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912513888 | Lauran Simpson | Behavior Technician | 1237 Augusta West Parkway, Augusta, GA 30909 | 2020-09-16 |
| 1487273884 | Still Perspectives Counseling LLC | Counselor | 1265 Inerstate Prwy, Suite B, Augusta, GA 30909 | 2020-04-15 |
| 1598397838 | Mjra Medical LLC | Psychologist | 3675 J Dewey Gray Cr Ste 300, Augusta, GA 30909 | 2020-02-05 |
| 1003452319 | Danny Robinson | Counselor | 2609 Commons Boulevard, Augusta, GA 30909 | 2019-11-21 |
| 1407498637 | Candice M Cruse | Social Worker | 2609 Commons Blvd, Augusta, GA 30909 | 2019-10-09 |
| 1902363385 | Mary D Jodon | Pharmacist | 3338 Wrightsboro Rd., Augusta, GA 30909 | 2019-02-21 |
| 1447790514 | Burn Critical Care Associates, LLC | Internal Medicine | 3614 J. Dewey Gray Circle, Bldg B., Augusta, GA 30909 | 2017-03-08 |
| 1124561766 | Sasha Latara Mccraw | Counselor | 7303 Palomino Court, Augusta, GA 30909 | 2016-11-30 |
| 1174974620 | Warren Umansky, Ph.d. | Psychologist | 302 Wheeler Executive Ctr, Augusta, GA 30909 | 2016-06-27 |
| 1811358955 | Theodora Mcleskey | Nurse Practitioner | 1215 George C. Wilson Drive, Augusta, GA 30909 | 2016-03-17 |
| Find all providers in zip 30909 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437383247 | Juanita G Trimor Md PC | Clinic/Center | 1232 Augusta West Pkwy, Augusta, GA 30909-1854 | 2009-05-07 |
| 1861632382 | Expresshealth Inc. | Clinic/Center | 1220 George C. Wilson Drive, Suite A, Augusta, GA 30909-3471 | 2009-02-24 |
| 1902824618 | Neighborhood Improvement Project, Inc. | Clinic/Center | 2467 Golden Camp Rd, Augusta, GA 30906-5515 | 2006-07-18 |
| 1669637401 | Dr Spearman, M.d., P.C. | Clinic/Center | 820 Saint Sebastian Way, Suite 6 D, Augusta, GA 30901-2643 | 2008-07-21 |
| 1306029434 | Wrightsboro Medical Center | Clinic/Center | 3207 Wrightsboro Rd, Augusta, GA 30909-2941 | 2007-12-12 |
| 1558544684 | Beulah Grove Community Resource Center | Clinic/Center | 1448 Lee Beard Way, Augusta, GA 30901-3414 | 2007-12-12 |
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| 1598389637 | Mercie Health | Clinic/Center | 3721 New Macland Rd Ste 246, Powder Springs, GA 30127-2000 | 2020-06-04 |
| 1366061699 | Beyondmed LLC | Clinic/Center | 1820 Willow Branch Ln Nw, Kennesaw, GA 30152-4558 | 2020-04-16 |
| 1366082596 | Rock Health Inc | Clinic/Center | 5385 Five Forks Trickum Rd Ste F, Stone Mountain, GA 30087-3018 | 2020-01-15 |
| 1477192219 | Meridian Corporate Healthcare of Georgia P C | Clinic/Center | 5163 Thompson Bridge Rd, Murrayville, GA 30564-1930 | 2019-12-26 |
| Find all providers with the same taxonomy | ||||
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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.