DAFFODIL PEDIATRICS AND FAMILY MEDICINE (NPI# 1851663124) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851663124 |
| Entity Type | Organization |
| Organization Name | DAFFODIL PEDIATRICS AND FAMILY MEDICINE |
| Practice Address |
4905 Courtney Drive Forest Park GA 30297 |
| Practice Telephone | 4043663636 |
| Practice Fax Number | 4043620808 |
| Mailing Telephone | 4043663636 |
| Mailing Fax Number | 4043620808 |
| Enumeration Date | 2012-02-02 |
| Last Update Date | 2013-09-16 |
| Authorized Official Name | JON FREDERICK STACHELRODT (CEO) |
| Authorized Official Telephone | 3104298614 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| Street Address |
4905 COURTNEY DRIVE |
| City | FOREST PARK |
| State | GA |
| Zip Code | 30297 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548747173 | Ga Peach Medical Transportation, LLC | Ambulance | 5023 Highway 85, Forest Park, GA 30297 | 2018-07-26 |
| 1871940437 | Crystal Harrison | Counselor | 4659 Ruby Ln, Forest Park, GA 30297 | 2016-05-24 |
| 1467807156 | Naundria Jackson | Nurse Practitioner | Apmc, Forest Park, GA 30297 | 2016-04-29 |
| 1891156089 | Gentle Care Medical Trans LLC | Ambulance | 530 Forest Parkway Suite B, Forest Park, GA 30297 | 2016-03-15 |
| 1811318835 | Kim Mckinney | Case Manager/Care Coordinator | 1104 South Parkwood Drive, Forest Park, GA 30297 | 2013-12-17 |
| 1215361910 | Tiffany Nadine Adams | Specialist | 228 Morrow Rd 18h, Forest Park, GA 30297 | 2013-08-29 |
| 1093093759 | Truliant Health Systems | Community/Behavioral Health | 526 Forest Parkway Ste D, Forest Park, GA 30297 | 2011-07-29 |
| 1811134133 | Sharonda Renee Forte | Orthopaedic Surgery | 4940 Governors Park Drive, Forest Park, GA 30297 | 2009-01-08 |
| 1215173737 | Comfort Personal Care Service | Assisted Living Facility | 5530 Old Dixie Highway, D-9, Forest Park, GA 30297 | 2009-01-06 |
| 1730360264 | American Foot & Leg Specialists, P.C. | Clinic/Center | 425 Forest Pkwy Ste 103, Forest Park, GA 30297 | 2007-11-27 |
| Find all providers in zip 30297 | ||||
| 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 |
|---|---|---|---|---|
| 1841616653 | Clear Medical Concepts LLC | Pediatrics | 526 Forest Pkwy, Suite K, Forest Park, GA 30297-6140 | 2014-03-17 |
| 1174652911 | Sherica Nicole Rosser | Pediatrics | 526 Forest Pkwy Ste K, Forest Park, GA 30297-6140 | 2007-03-05 |
| 1356387682 | Rajamani S Iyer | Pediatrics | 561 Forest Pkwy, Suite 1 & 2, Forest Park, GA 30297-6135 | 2006-06-22 |
| 1598719783 | Rigoberto Tapia | Pediatrics | 7318 Madison St, Suite #2, Forest Park, IL 60130-3100 | 2006-05-20 |
| 1477537322 | Abigail Kamishlian | Pediatrics | 4905 Courtney Dr, Forest Park, GA 30297-1427 | 2005-12-05 |
| 1386051712 | Fahimot Oyinlola Faduyile | Pediatrics | 4905 Courtney Dr, Forest Park, GA 30297-1427 | 2014-07-17 |
| 1861827891 | Nancy Elizabeth Clines | Pediatrics | 4905 Courtney Dr, Forest Park, GA 30297-1427 | 2013-09-10 |
| 1437449964 | Daliannys Morales Mendez | Pediatrics | 4905 Courtney Dr, Forest Park, GA 30297-1427 | 2011-04-18 |
| 1588983514 | Crystal Mercia Malvoisin | Pediatrics | 4905 Courtney Dr, Forest Park, GA 30297-1427 | 2010-06-01 |
| 1780821884 | Shonte Henderson | Pediatrics | 4905 Courtney Dr, Forest Park, GA 30297-1427 | 2009-01-12 |
| Find all providers in FOREST PARK | ||||
| City | FOREST PARK |
| Zip Code | 30297 |
Please comment or provide details below to improve the information on DAFFODIL PEDIATRICS AND FAMILY MEDICINE.
| 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.