CENTER FOR PEDIATRIC WELLNESS, P.C. (NPI# 1922392190) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922392190 |
| Entity Type | Organization |
| Organization Name | CENTER FOR PEDIATRIC WELLNESS, P.C. |
| Practice Address |
960 Johnson Ferry Rd Ne Suite 315 Atlanta GA 30342-1631 |
| Practice Telephone | 4043891600 |
| Practice Fax Number | 4043891610 |
| Mailing Telephone | 4043891600 |
| Mailing Fax Number | 4043891610 |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2011-06-06 |
| Authorized Official Name | DR. ELIZABETH M. LEDUC (PRESIDENT) |
| Authorized Official Telephone | 4043891600 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 034754 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000553781B | 05 |
| Street Address |
960 JOHNSON FERRY RD NE SUITE 315 |
| City | ATLANTA |
| State | GA |
| Zip Code | 30342-1631 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033112198 | Alan I Segal | Audiologist | 960 Johnson Ferry Rd Ne, Ste 200, Atlanta, GA 30342-1631 | 2005-05-23 |
| 1245628957 | Maryann Reuben | Specialist/Technologist, Other | 960 Johnson Ferry Rd Ne, Suite 120, Atlanta, GA 30342 | 2015-01-05 |
| 1679917835 | Comprehensive Internal Medicine At Northside | Internal Medicine | 960 Johnson Ferry Rd Ne, Suite 543, Atlanta, GA 30342-1631 | 2013-04-18 |
| 1881957553 | Allison M Sugg | Physician Assistant | 960 Johnson Ferry Rd Ne, Suite 200, Atlanta, GA 30342-1631 | 2012-06-19 |
| 1780910737 | Faraa Mobini | Physician Assistant | 960 Johnson Ferry Rd Ne, Suite 200, Atlanta, GA 30342-1631 | 2009-10-27 |
| 1376779322 | Village Podiatry Group, P.C. | Podiatrist | 960 Johnson Ferry Rd Ne, Suite 310, Atlanta, GA 30342-1631 | 2009-06-04 |
| 1255597282 | Plastic Surgery Institute of Atlanta, P.C. | Plastic Surgery | 960 Johnson Ferry Rd Ne, Suite 245, Atlanta, GA 30342-1631 | 2008-07-30 |
| 1912165382 | Mervyn B Forman Md, L.l.c | Internal Medicine | 960 Johnson Ferry Rd Ne, Ste 530, Atlanta, GA 30342-1631 | 2008-06-02 |
| 1275722811 | Raymond V. Caputo, M.d.,p.c. | Dermatology | 960 Johnson Ferry Rd Ne, Suite 226, Atlanta, GA 30342-1631 | 2007-10-19 |
| 1942408984 | Cindy L Hirsch | Audiologist | 960 Johnson Ferry Rd Ne, Suite 200, Atlanta, GA 30342-1631 | 2007-07-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144820614 | Nia Charnice Griffin | Nurse Practitioner | 5670 Peachtree Dunwoodyroad, Suite 900, Atlanta, GA 30342 | 2020-10-26 |
| 1255945184 | Jennifer Lynne Cole | Behavior Technician | 5555 Glenridge Con Suite 200, Atlanta, GA 30342 | 2020-09-08 |
| 1093336232 | Van Tran | Respiratory Therapist, Registered | 1000 Johnson Ferry Rd Ne, Atlanta, Ga 30342, Atlanta, GA 30342 | 2020-04-28 |
| 1356978340 | Twyla Douglas Jackson I | Clinical Nutrition, 1000 Johnson Ferry Rd Ne, Atlanta, GA 30342 | 2020-03-27 | |
| 1760013411 | Emily Hamm | Dietitian, Registered | 933 D Johnson Ferry Road, Suite 250, Atlanta, GA 30342 | 2020-01-31 |
| 1043855984 | Mackenzie Tucker Wayda | Registered Nurse | 1001 Johnson Ferry Rd. Ne, Atlanta, GA 30342 | 2019-11-14 |
| 1386288454 | Tiauna Lashun Cochman | Psychologist | 1307 Glenridge Dr, Sandy Springs, GA 30342 | 2019-11-01 |
| 1164074399 | Stephen J. White | Hearing Instrument Specialist | 5775 Peachtree Dunwoody Rd Suite 600 Fl. 6, Uhc Hearing, Atl., GA 30342 | 2019-07-09 |
| 1144788142 | Jaytyn LLC | Internal Medicine | 4600 Broswell Road, Atlanta, GA 30342 | 2019-03-08 |
| 1760954705 | Mishele Walker LLC | Counselor | 555 Glenridge Connector, Suite 200, Sandy Springs, GA 30342 | 2018-12-31 |
| Find all providers in zip 30342 | ||||
| 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 |
|---|---|---|---|---|
| 1588219810 | Dayana Regis | Pediatrics | 808 York Ave Sw, Atlanta, GA 30310 | 2019-08-04 |
| 1922660547 | Taylor Noelle Hemmerick | Pediatrics | 312 Highland Square Dr Ne, Atlanta, GA 30306-2283 | 2019-07-03 |
| 1710499983 | Muin Joseph Khoury | Pediatrics | 1923 Mercedes Ct Ne, Atlanta, GA 30345-3939 | 2017-10-27 |
| 1730602459 | Brandi Jo Middour-oxler | Pediatrics | 1605 Chantilly Dr Ne Ste 305, Atlanta, GA 30324-3267 | 2017-07-25 |
| 1043743354 | Sally Azer | Pediatrics | 2015 Uppergate Drive 423b, Atlanta, GA 30322-1910 | 2017-04-05 |
| 1588027502 | Lauren Roach | Pediatrics | 2015 Uppergate Drive Rm 534, Atlanta, GA 30322-0001 | 2016-03-29 |
| 1760858252 | Baybol Pediatrics LLC | Pediatrics | 9 Dunwoody Park Ste 126, Atlanta, GA 30338-6712 | 2015-08-19 |
| 1174919500 | John Charles Watson | Pediatrics | 2616 Varner Dr Ne, Atlanta, GA 30345-1559 | 2015-04-13 |
| 1679967582 | Elizabeth Sinclair | Pediatrics | Pediatric Divisions of Gi and Transplant Hepatology, 2015 Uppergate Drive Ne, Atlanta, GA 30322 | 2015-03-28 |
| 1447644430 | Juhi Jain | Pediatrics | 2015 Uppergate Drive Emory Children's Center #400, Atlanta, GA 30322 | 2015-03-27 |
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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.