PEDIATRIC CARDIOLOGY SERVICES LLC (NPI# 1467613232) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467613232 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC CARDIOLOGY SERVICES LLC |
| Practice Address |
1380 Milstead Ave Ne Suite J Conyers GA 30012-3864 |
| Mailing Address |
500 Medical Center Blvd Suite 340 Lawrenceville GA 30045 |
| Practice Telephone | 7709956684 |
| Practice Fax Number | 7709957631 |
| Mailing Telephone | 7709956684 |
| Mailing Fax Number | 7709957631 |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2008-06-24 |
| Authorized Official Name | MS. KIM WOODY (PRACTICE ADMINISTRATOR) |
| Authorized Official Telephone | 7709956684 |
| Authorized Official Credential | RMM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0202X |
Pediatrics Specialization: Pediatric Cardiology |
043298 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000326873G | 05 | |
| GA | 00740891A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922269794 | Pediatric Cardiology Services LLC | Pediatrics | 980 Johnson Ferry Rd Ne, Suite 560, Atlanta, GA 30342-1626 | 2008-06-24 |
| 1003077876 | Pediatric Cardiology Services LLC | Pediatrics | 200 S Enota Dr Ne, Suite 380, Gainesville, GA 30501-3473 | 2008-06-24 |
| Street Address |
1380 MILSTEAD AVE NE SUITE J |
| City | CONYERS |
| State | GA |
| Zip Code | 30012-3864 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609845403 | Jack Donald James | Specialist | 1380 Milstead Ave Ne, Suite B, Conyers, GA 30012-3864 | 2006-03-15 |
| 1932507423 | Md Precision Lab | Clinical Medical Laboratory | 1380 Milstead Ave Ne, Ste J, Conyers, GA 30012-3864 | 2014-12-15 |
| 1063752913 | Conyers Internal Medicine LLC | Internal Medicine | 1380 Milstead Ave Ne, Ste C, Conyers, GA 30012-3864 | 2013-02-28 |
| 1275872632 | Colon & Digestive Health Specialists LLC | Internal Medicine | 1380 Milstead Ave Ne, Ste C, Conyers, GA 30012-3864 | 2013-02-05 |
| 1295008563 | Shiraz Habib Kassam | Obstetrics & Gynecology | 1380 Milstead Ave Ne, Conyers, GA 30012-3864 | 2012-02-17 |
| 1346538881 | Julianne Adams Birt, Md, LLC | Obstetrics & Gynecology | 1380 Milstead Ave Ne, Suite F, Conyers, GA 30012-3864 | 2011-07-19 |
| 1619093788 | Serenity Health Care and Hospice | Hospice Care, Community Based | 1380 Milstead Ave Ne, Suite H, Conyers, GA 30012-3864 | 2007-03-21 |
| 1639216450 | Holly Anne Imlach | Obstetrics & Gynecology | 1380 Milstead Ave Ne, Suite E, Conyers, GA 30012-3864 | 2007-01-31 |
| 1699823245 | The Atlanta Cardioloyg Group, PC | Internal Medicine | 1380 Milstead Ave Ne, Suite E, Conyers, GA 30012-3864 | 2007-01-08 |
| 1700946258 | Karim Shakoor, M.d.,p.c. | Internal Medicine | 1380 Milstead Ave Ne, Suite-c, Conyers, GA 30012-3864 | 2006-12-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578188306 | The Eye Md | Ophthalmology | 1359 Milstead Road, Suite #103, Conyers, GA 30012 | 2020-06-08 |
| 1043855836 | Maurvet Minto | Counselor | 1175 Green St, Conyers, Conyers, GA 30012 | 2019-11-15 |
| 1770054561 | Sarah Elizabeth Brooks | Physical Medicine & Rehabilitation | 1290 Milstead Ave Ne, Conyers, GA 30012 | 2018-12-06 |
| 1679091276 | Valorie Antoinette Jones | Counselor | 1175 Green St Se, Conyers, GA 30012 | 2017-09-02 |
| 1558886341 | Synergy Radiology, LLC | Radiology | 1501 Milstead Road, Suite 140, Conyers, GA 30012 | 2017-08-14 |
| 1558813295 | Salon Lyon, LLC | Specialist | 1112 West Ave, Se, B, Conyers, GA 30012 | 2016-10-28 |
| 1992252753 | Traci Hunter Bryan | Pharmacist | 1501 Milstead Ave Ne, Suite 110, Conyers, GA 30012 | 2016-09-08 |
| 1316491830 | Hye Rim Kim | Anesthesiologist Assistant | 1380 Milstead Rd Ne, Suite G, Conyers, GA 30012 | 2016-08-12 |
| 1235591397 | David Jeffrey Wasserman | Optometrist | 1192 Dogwood Dr Sw, Conyers, GA 30012 | 2016-03-28 |
| 1174919187 | Anique Archer | Health Educator | 2170 Lester Rd Nw, Conyers, GA 30012 | 2015-04-07 |
| Find all providers in zip 30012 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 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.