PRINCETON LAKES PEDIATRICS, LLC (NPI# 1518236645) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518236645 |
| Entity Type | Organization |
| Organization Name | PRINCETON LAKES PEDIATRICS, LLC |
| Practice Address |
3885 Princeton Lakes Way Sw Suite 302 Atlanta GA 30331-5589 |
| Practice Telephone | 4046291880 |
| Practice Fax Number | 4046291935 |
| Mailing Telephone | 4046291880 |
| Mailing Fax Number | 4046291935 |
| Enumeration Date | 2011-12-19 |
| Last Update Date | 2012-01-04 |
| Authorized Official Name | DEKISHA DRAYTON (OWNER) |
| Authorized Official Telephone | 4046291880 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 053016 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
3885 PRINCETON LAKES WAY SW SUITE 302 |
| City | ATLANTA |
| State | GA |
| Zip Code | 30331-5589 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811989478 | Lisa C Perry-gilkes | Otolaryngology | 3885 Princeton Lakes Way Sw, Suite 312a, Atlanta, GA 30331-5589 | 2005-08-19 |
| 1861933178 | Southwest Atlanta Vascular Care, LLC | Radiology | 3885 Princeton Lakes Way Sw, Suite 314, Atlanta, GA 30331-5589 | 2017-03-20 |
| 1598127540 | Interventional Spine and Pain Management Center, PC | Pain Medicine | 3885 Princeton Lakes Way Sw, Atlanta, GA 30331-5589 | 2016-03-28 |
| 1326409566 | Interventional Spine and Pain Management Center, PC | Pain Medicine | 3885 Princeton Lakes Way Sw, Suite 225, Atlanta, GA 30331-5589 | 2016-03-16 |
| 1811357080 | S.val Plastic Surgery P.C. | Plastic Surgery | 3885 Princeton Lakes Way Sw, Suite 312, Atlanta, GA 30331-5589 | 2016-03-02 |
| 1366841744 | Southern Crescent Physicians Group, Inc | Psychiatry & Neurology | 3885 Princeton Lakes Way Sw, Atlanta, GA 30331-5589 | 2014-08-21 |
| 1205267192 | Wellstar Medical Group, LLC | Internal Medicine | 3885 Princeton Lakes Way Sw, Suite 300, Atlanta, GA 30331-5589 | 2013-12-03 |
| 1942548870 | Ispm Asc At Camp Creek LLC | Clinic/Center | 3885 Princeton Lakes Way Sw, Ste 400, Atlanta, GA 30331-5589 | 2013-01-28 |
| 1447594106 | Ispm Asc At Camp Creek LLC | Clinic/Center | 3885 Princeton Lakes Way Sw, Suite 400, Atlanta, GA 30331-5589 | 2012-11-19 |
| 1356685390 | Camp Creek LLC | Specialist | 3885 Princeton Lakes Way Sw, Ste 400, Atlanta, GA 30331-5589 | 2012-11-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861001174 | Whitney Flemister | Social Worker | 3961 Princeton Lakes Way Sw, Atlanta, GA 30331 | 2020-07-23 |
| 1982237400 | Publix Super Markets, Inc. | Durable Medical Equipment & Medical Supplies | 5829 Campbellton Road, S.w, Suite 110, Atlanta, GA 30331 | 2020-02-13 |
| 1295375558 | Drusilla Precious Cudjoe | Behavior Technician | 3800 Camp Creek Parkway Sw, Building 1400, Atlanta, GA 30331 | 2020-01-14 |
| 1497262778 | Champions Pharmacy | Pharmacy | 3886 Princeton Lakes Way Suite 180, Atlanta, GA 30331 | 2018-01-08 |
| 1033629779 | Carmen Ardoin | Counselor | 2636 Martin Luther King Jr. Drive, Suite 12, Atlanta, GA 30331 | 2017-10-09 |
| 1346759974 | Neva R Allison | Nurse Practitioner | 2611 Dayview Ln, Atlanta, GA 30331 | 2017-09-26 |
| 1538678255 | Natalie Mckay | Technician/Technologist | 3915 Cascade Rd, 220, Atlanta, GA 30331 | 2017-09-26 |
| 1700304268 | Tyrone Pipkin | Contractor | 415 Kendrick Terrace Sw, Atlanta, GA 30331 | 2017-09-05 |
| 1073031688 | Kristen Wooldridge | Pharmacist | 3695 Cascade Road, Atlanta, GA 30331 | 2017-09-04 |
| 1548704687 | Advance Pain Management | Health Maintenance Organization | 2950 Stone Hogan Road Connector, Atlanta, GA 30331 | 2016-12-08 |
| Find all providers in zip 30331 | ||||
| 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.