BRASELTON PEDIATRICS, PC (NPI# 1194974907) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194974907 |
| Entity Type | Organization |
| Organization Name | BRASELTON PEDIATRICS, PC |
| Practice Address |
1897 Highway 211 Nw Suite 100 Hoschton GA 30548 |
| Mailing Address |
1651 Tailmore Ln Lawrenceville GA 30043-7862 |
| Practice Telephone | 6788207979 |
| Practice Fax Number | 6788207980 |
| Mailing Telephone | 6788207979 |
| Enumeration Date | 2008-09-17 |
| Last Update Date | 2008-09-17 |
| Authorized Official Name | MARC-YRIANE BORIEUX (PRESIDENT) |
| Authorized Official Telephone | 4197878685 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
GA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| STATE OF GEORGIA MEDICAL LICENSE | 059604 | 01 | |
| GA | NPI | 1700095742 | 01 |
| Street Address |
1897 HIGHWAY 211 NW SUITE 100 |
| City | HOSCHTON |
| State | GA |
| Zip Code | 30548 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700095742 | Marc-yriane Borieux | Pediatrics | 1897 Highway 211 Nw, Suite 100, Hoschton, GA 30548-3513 | 2007-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386108587 | Lan Tran Schlecht | Social Worker | 255 Lamar Ln, Hoschton, GA 30548 | 2019-01-22 |
| 1265932560 | Carley Costner | Chiropractor | 280 Cambridge Farms Dr, Hoschton, GA 30548 | 2018-02-14 |
| 1285906263 | Loving Hearts Helping Hands Senior Homecare | Home Health | 2011 Maddox Road, Hoschton, GA 30548 | 2012-02-06 |
| 1588967376 | Pamela Ann Reagin | Massage Therapist | 4397 Hwy 53, Hoschton, GA 30548 | 2010-12-16 |
| 1144523176 | David Chandler Bell | Chiropractor | 55 Freedom Parkway, Suite 112, Hoschton, GA 30548 | 2010-12-14 |
| 1275781361 | Georgia Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 5848 Hwy 124 West, Hoschton, GA 30548 | 2008-09-03 |
| 1972635407 | Cognitive Behavioral Health LLC | Counselor | 5415 Thompson Mill Road Ste B, Dr Devin Vicknair, Hoschton, GA 30548 | 2007-03-10 |
| 1336203454 | Robert Lee Cornett | Physical Therapist | 5415 Thompson Mill Road, Hoschton, GA 30548 | 2006-12-21 |
| 1790846426 | West Jackson Medicine Center, Inc | Durable Medical Equipment & Medical Supplies | 3845 Hwy 53, Hoschton, GA 30548 | 2006-12-13 |
| 1235140773 | Jennifer Hawk Wiley | Chiropractor | 117 Bell Avenue, Hoschton, GA 30548 | 2006-08-10 |
| Find all providers in zip 30548 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598376865 | Deyoe Wellness | Clinic/Center | 47 Commerce Dr Ste 1b, Blairsville, GA 30512-8929 | 2020-08-11 |
| 1992331581 | World Spine and Orthopedics LLC | Clinic/Center | 4296 Memorial Dr Ste C, Decatur, GA 30032-1227 | 2020-03-16 |
| 1619517968 | Carroll Total Healthcare,pc | Clinic/Center | 410 Peachtree Pkwy Ste 4226, Cumming, GA 30041-7439 | 2020-01-14 |
| 1528601200 | Blued Consultant Solutions, LLC | Clinic/Center | 256 Rainbow Ln, Mcdonough, GA 30252-4839 | 2019-10-24 |
| 1578113585 | Centro Prenatal De Gwinnett LLC | Clinic/Center | 575 W Pike St Ste 1, Lawrenceville, GA 30046-7685 | 2019-09-12 |
| 1316508815 | Atlanta Health Clinic LLC | Clinic/Center | 2480 Windy Hill Rd Se Ste 404, Marietta, GA 30067-8658 | 2019-06-25 |
| 1659880847 | Jones Medical and Educational Consultants | Clinic/Center | 8954 Hospital Dr Bldg C, Douglasville, GA 30134-2200 | 2017-09-20 |
| 1477005593 | Hirenirali LLC | Clinic/Center | 12390 Beragio Pl, Alpharetta, GA 30004-4188 | 2016-10-25 |
| 1851840961 | Tele Doctor Direct Inc | Clinic/Center | 1250 Powers Ferry Cmn Se, Suite 100, Marietta, GA 30067-6046 | 2016-09-30 |
| 1154870533 | Life Point Medical, LLC | Clinic/Center | 189 Bo James Street, Suite 105, Clayton, GA 30525 | 2016-09-27 |
| 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.