SCOTTISH RITE CHILDREN'S MEDICAL CENTER (NPI# 1184779332) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184779332 |
| Entity Type | Organization |
| Organization Name | SCOTTISH RITE CHILDREN'S MEDICAL CENTER |
| Other Organization Name | CHILDREN'S HEALTHCARE OF ATLANTA AT SCOTTISH RITE |
| Practice Address |
1001 Johnson Ferry Rd Ne Atlanta GA 30342-1605 |
| Mailing Address |
1575 Northeast Expy Ne Brookhaven GA 30329-2401 |
| Practice Telephone | 4047855252 |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2020-10-23 |
| Authorized Official Name | HAYDEN MATHIESON (VICE PRESIDENT, MANAGED CARE) |
| Authorized Official Telephone | 4047850589 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103G00000X | Clinical Neuropsychologist | Behavioral Health & Social Service Providers | ||
| N | 122300000X | Dentist | Dental Providers | ||
| N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers | ||
| N | 207ZP0213X |
Pathology Specialization: Pediatric Pathology |
Allopathic & Osteopathic Physicians | ||
| N | 2080P0204X |
Pediatrics Specialization: Pediatric Emergency Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 2081P0010X |
Physical Medicine & Rehabilitation Specialization: Pediatric Rehabilitation Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 208M00000X | Hospitalist | Allopathic & Osteopathic Physicians | ||
| N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 2080P0207X |
Pediatrics Specialization: Pediatric Hematology-Oncology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Children's Healthcare of Atlanta at Scottish Rite | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285932814 | Scottish Rite Children's Medical Center | Prosthetic/Orthotic Supplier | 410 Peachtree Pkwy, Suite 300, Cumming, GA 30041-7066 | 2011-03-07 |
| 1619290277 | Scottish Rite Children's Medical Center | Prosthetic/Orthotic Supplier | 175 White St Nw, Suite 350, Marietta, GA 30060-1053 | 2010-03-10 |
| 1972732212 | Scottish Rite Children's Medical Center | Prosthetic/Orthotic Supplier | 3300 Old Milton Pkwy, Alpharetta, GA 30005-2423 | 2009-07-08 |
| Street Address |
1001 JOHNSON FERRY RD NE |
| City | ATLANTA |
| State | GA |
| Zip Code | 30342-1605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841287331 | Natavut Punyasavatsut | Pediatrics | 1001 Johnson Ferry Rd Ne, Atlanta, GA 30342-1605 | 2005-09-30 |
| 1982161196 | Allie Jones Chappell | Registered Nurse | 1001 Johnson Ferry Rd Ne, Atlanta, GA 30342 | 2019-02-24 |
| 1255759494 | Sean Spencer Evans | Otolaryngology | 1001 Johnson Ferry Rd Ne, Atlanta, GA 30322-1900 | 2014-04-04 |
| 1174864433 | Sarah Sharpless | Nurse Practitioner | 1001 Johnson Ferry Rd Ne, Atlanta, GA 30342-1605 | 2013-03-12 |
| 1114267903 | Kristen Charbonnet Cranmer | Nurse Practitioner | 1001 Johnson Ferry Rd Ne, Atlanta, GA 30342-1605 | 2013-02-15 |
| 1861743858 | Natalie Dinsmore | Anesthesiologist Assistant | 1001 Johnson Ferry Rd Ne, Atlanta, GA 30342-1605 | 2012-10-01 |
| 1346598539 | Melinda Mayton | Nurse Practitioner | 1001 Johnson Ferry Rd Ne, Atlanta, GA 30342-1605 | 2012-08-21 |
| 1548518699 | Bonnie Burke | Nurse Practitioner | 1001 Johnson Ferry Rd Ne, Atlanta, GA 30342-1605 | 2012-08-21 |
| 1356697387 | Mary Alisha Gates | Nurse Practitioner | 1001 Johnson Ferry Rd Ne, Atlanta, GA 30342-1605 | 2012-07-27 |
| 1659632461 | Heather Hammond Post | Nurse Practitioner | 1001 Johnson Ferry Rd Ne, Atlanta, GA 30342-1605 | 2012-06-07 |
| 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 | 2080P0207X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Hematology-Oncology |
| A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases. |
| 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 |
|---|---|---|---|---|
| 1518386853 | Rafi Kazi | Pediatrics | 5461 Meridian Mark Rd, Atlanta, GA 30342-3007 | 2014-04-15 |
| 1871936823 | Michael Hugh White | Pediatrics | 5461 Meridian Mark Road Ne, Suite 400, Atlanta, GA 30342 | 2013-04-09 |
| 1568624351 | Gary M Woods | Pediatrics | 5455 Meridian Marks Rd Ste 400, Atlanta, GA 30342 | 2008-07-02 |
| 1295993087 | Karen Elizabeth Effinger | Pediatrics | 2015 Uppergate Dr Fl 4, Atlanta, GA 30322-2200 | 2008-05-28 |
| 1114007549 | Robert Craig Castellino | Pediatrics | 14015 Clifton Rd, Atlanta, GA 30322-0001 | 2006-10-17 |
| 1295799161 | Glen Lew | Pediatrics | 5455 Meridian Mark Rd, Suite 400, Atlanta, GA 30342-1654 | 2006-04-17 |
| 1417916768 | Carolyn M Bennett | Pediatrics | 1450 Clifton Rd Ne, 4th Floor, Atlanta, GA 30322-1053 | 2006-03-23 |
| 1275504169 | Tamara N New | Pediatrics | Aflac Cancer Center and Blood Disorders Service, Scottish Rite, 5455 Meridian Mark Rd, Suite 400, Atlanta, GA 30342 | 2006-01-30 |
| 1235664343 | Sharmila Raghunandan | Pediatrics | 1405 Clifton Rd Ne, Atlanta, GA 30322-1060 | 2017-04-26 |
| 1376961730 | Anthony Ross | Pediatrics | 100 Woodruff Cir Ne Ste 327, Atlanta, GA 30322-1334 | 2014-04-02 |
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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.