PEDIATRIC CARDIOLOGY SERVICES, LLC (NPI# 1174813737) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174813737 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC CARDIOLOGY SERVICES, LLC |
| Practice Address |
500 Medical Center Blvd Suite 390 Lawrenceville GA 30046-8708 |
| Practice Telephone | 7709956684 |
| Practice Fax Number | 7709957631 |
| Mailing Telephone | 7709956684 |
| Mailing Fax Number | 7709957631 |
| Enumeration Date | 2011-04-15 |
| Last Update Date | 2012-09-12 |
| Authorized Official Name | NEILL VIDELEFSKY (CEO) |
| Authorized Official Telephone | 7709956684 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0202X |
Pediatrics Specialization: Pediatric Cardiology |
GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000740891A | 05 | |
| GA | 000326873G | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013177310 | Pediatric Cardiology Services, LLC | Pediatrics | 500 Medical Center Blvd, Suite 340, Lawrenceville, GA 30045-8708 | 2008-06-11 |
| Street Address |
500 MEDICAL CENTER BLVD SUITE 390 |
| City | LAWRENCEVILLE |
| State | GA |
| Zip Code | 30046-8708 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902802515 | Princewill U Ehirim | Neurological Surgery | 500 Medical Center Blvd, Suite 200, Lawrenceville, GA 30045-8708 | 2005-06-28 |
| 1619594520 | Jennifer Hall Mckenzie | Nurse Practitioner | 500 Medical Center Blvd, Lawrenceville, GA 30046-8708 | 2020-06-26 |
| 1295273571 | Amy Davidson | Nurse Practitioner | 500 Medical Center Blvd, Suite 365, Lawrenceville, GA 30046-8708 | 2017-02-07 |
| 1609244532 | Gwinnett Emergency Specialists, P.C. | General Acute Care Hospital | 500 Medical Center Blvd, Lawrenceville, GA 30046-8708 | 2015-09-09 |
| 1770950578 | Elizabeth Nicole Gray | Nurse Practitioner | 500 Medical Center Blvd, Suite 210, Lawrenceville, GA 30046-8708 | 2015-08-27 |
| 1609258870 | Josephine Brinkley | Nurse Practitioner | 500 Medical Center Blvd, Suite 310, Lawrenceville, GA 30046-8708 | 2015-06-24 |
| 1235523937 | Ehi Pharmacy Solutions, LLC. | Non-Pharmacy Dispensing Site | 500 Medical Center Blvd, Ste. 100, Lawrenceville, GA 30046-8708 | 2015-03-20 |
| 1386995470 | Plastic Surgery of Gwinnett PC | Specialist | 500 Medical Center Blvd, Suite 150, Lawrenceville, GA 30046-8708 | 2012-09-28 |
| 1053677856 | Jacqueline Bays Runyan | Counselor | 500 Medical Center Blvd, Suite 290, Lawrenceville, GA 30046-8708 | 2012-04-05 |
| 1912281429 | Pediatric Cardiology Services | Pediatrics | 500 Medical Center Blvd, 340, Lawrenceville, GA 30046-8708 | 2011-10-03 |
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|---|---|---|---|---|
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| 1285259846 | Mesun Health Services, Inc | Clinical Nurse Specialist | 88 Johnson Rd Building # 1-b, Lawrenceville, GA 30046 | 2020-06-10 |
| 1215550264 | Mesun Health Services, Inc | Skilled Nursing Facility | 88 Johnson Rd. Building #2, Lawrenceville, GA 30046 | 2020-05-26 |
| 1306499785 | Bryan Acosta | Chiropractor | 471 Scenic Hwy South, Lawrenceville, GA 30046 | 2019-07-24 |
| 1205308616 | Belle Lumiere Cosmetics LLC | Dermatology | 753 Old Norcross Road, Lawrenceville, GA 30046 | 2018-12-24 |
| 1548730179 | Alexis Nicole Robinson | Nurse Anesthetist, Certified Registered | 1000 Medical Center Boulevard, Lawrenceville, GA 30046 | 2018-11-27 |
| 1679060388 | Christopher Puckett | Student in an Organized Health Care Education/Training Program | 665 Duluth Hwy Suite 501, Lawrenceville, GA 30046 | 2018-04-18 |
| 1457851255 | Advanced Urology Institute of Georgia | Urology | 501 Crown Point Way, Lawrenceville, GA 30046 | 2018-02-19 |
| 1013447044 | Pharmacy Investments of Lawrenceville, LLC | Pharmacy | 738 Old Norcross Road, Ste A, Lawrenceville, GA 30046 | 2017-06-13 |
| 1225577000 | Priority Housecalls LLC | Clinic/Center | 225 Scenic Hwy, Ste 200, Lawrenceville, GA 30046 | 2017-02-14 |
| Find all providers in zip 30046 | ||||
| Taxonomy Code | 2080P0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Cardiology |
| A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease. |
| 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) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912281429 | Pediatric Cardiology Services | Pediatrics | 500 Medical Center Blvd, 340, Lawrenceville, GA 30046-8708 | 2011-10-03 |
| 1013177310 | Pediatric Cardiology Services, LLC | Pediatrics | 500 Medical Center Blvd, Suite 340, Lawrenceville, GA 30045-8708 | 2008-06-11 |
| 1851300305 | Neill Videlefsky | Pediatrics | 500 Medical Center Blvd, Suite 390, Lawrenceville, GA 30046-8708 | 2006-08-05 |
| 1326057886 | Shiva Sharma | Pediatrics | 500 Medical Center Blvd, Suite 340, Lawrenceville, GA 30045-8708 | 2006-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679013452 | Baptist Specialty Physicians Inc | Pediatrics | 3301 N Oak St Ext, Valdosta, GA 31605 | 2017-02-28 |
| 1720408800 | Andrew Porter | Pediatrics | 202 Village Center Pkwy, Stockbridge, GA 30281-9044 | 2014-04-16 |
| 1689606782 | Albert Tuboku-metzger | Pediatrics | 202 Village Center Parkway, Stockbridge, GA 30281 | 2006-07-07 |
| 1992746929 | Deepti Singh | Pediatrics | 2069 Teron Trce, Suite 300, Dacula, GA 30019-1665 | 2006-06-09 |
| 1770521197 | Margaret J Strieper | Pediatrics | 1700 Tree Lane, Ste 330, Snellville, GA 30078 | 2006-06-04 |
| 1679523435 | Michael E Mcconnell | Pediatrics | 202 Village Ctr Parkway, Stockbridge, GA 30281 | 2006-05-11 |
| 1366491953 | Derek A Fyfe | Pediatrics | 1405 Clifton Rd, Atlanta, GA 30322 | 2006-05-09 |
| 1528017258 | William T Mahle | Pediatrics | 355 Tower Rd Ne Ste 204, Marietta, GA 30060-9413 | 2006-05-09 |
| 1548232036 | Lazaros K Kochilas | Pediatrics | 2835 Brandywine Road, Suite 300, Atlanta, GA 30341-5540 | 2006-02-07 |
| 1861485914 | Georgia Pediatric Cardiology | Pediatrics | 1045 Southcrest Dr, Ste 220, Stockbridge, GA 30281-6113 | 2005-08-24 |
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| City | LAWRENCEVILLE |
| Zip Code | 30046 |
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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.