SOUTHSIDE PEDIATRICS (NPI# 1659580215) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659580215 |
| Entity Type | Organization |
| Organization Name | SOUTHSIDE PEDIATRICS |
| Practice Address |
151 North Park Trail Suite A Stockbridge GA 30281-7373 |
| Practice Telephone | 6785653300 |
| Practice Fax Number | 6785653311 |
| Mailing Telephone | 6785653300 |
| Mailing Fax Number | 6785653311 |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2010-10-14 |
| Authorized Official Name | DR. RAVI S IYER (PRESIDENT) |
| Authorized Official Telephone | 6785653300 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 042292 | GA | Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | SOUTHSIDE PEDIATRICS P.C. | 502 Beech St, Farmville, Virginia 23901 |
| Indiana Business Entities | SOUTHSIDE PEDIATRICS REAL ESTATE, LLC | 7830 Mcfarland Lane, Indianapolis, IN 46237-4705 |
| Street Address |
151 NORTH PARK TRAIL SUITE A |
| City | STOCKBRIDGE |
| State | GA |
| Zip Code | 30281-7373 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164039095 | Colette Alls | Social Worker | 447 Lakeshore Dr, Stockbridge, GA 30281 | 2020-09-24 |
| 1982216800 | Pediatric and Family Behavioral Health of Georgia | Counselor | 1004 Ulster Court, Stockbridge, GA 30281 | 2020-08-21 |
| 1518577659 | Qunique Taveka Toxey | Behavior Technician | 115 N Park Trail, Suite 123, Stockbridge, GA 30281 | 2020-08-04 |
| 1497377675 | Melanie Harvey | Pharmacist | 4467 North Henry Boulevard, Stockbridge, GA 30281 | 2020-05-11 |
| 1114550571 | Cecile Maria Dunkley Layne | Counselor | 255 Corporte Drive, Stockbridge, GA 30281 | 2020-02-13 |
| 1306407143 | Palliative Care of Georgia. LLC | Home Health | 275 Corporate Center Court Ste C, Stockbridge, GA 30281 | 2019-06-24 |
| 1154883791 | Aaliyah Nura Fardan-alexander | Nurse's Aide | 105 Singletree, Stockbridge, GA 30281 | 2019-04-02 |
| 1306306261 | Prosthetic Care, Inc. | Prosthetic/Orthotic Supplier | 150 County Club Drive, Suite 200, Stockbridge, GA 30281 | 2019-03-25 |
| 1356814172 | Kristina Louissaint | Nurse Practitioner | 650 Country Club Dr, Stockbridge, GA 30281 | 2019-01-03 |
| 1942789284 | Cameren Barnes | Physical Therapist | 5473 N Henry Blvd, Stockbridge, GA 30281 | 2018-08-08 |
| Find all providers in zip 30281 | ||||
| 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 |
|---|---|---|---|---|
| 1558687962 | Meredith Gillis Dixon | Pediatrics | 1500 Hudson Bridge Rd, Stockbridge, GA 30281-5020 | 2010-04-09 |
| 1982834081 | Mary Lynn Epsten Chillemi | Pediatrics | 125 Eagles Walk Ste 150, Stockbridge, GA 30281-7207 | 2009-07-23 |
| 1649280512 | Najaz K Woods-bishop | Pediatrics | 1510 Hudson Bridge Rd, Stockbridge, GA 30281-5020 | 2006-08-09 |
| 1215944863 | Patrick Neal Pulliam | Pediatrics | 245 Country Club Dr Bldg 200a, Stockbridge, GA 30281-7212 | 2006-08-02 |
| 1770522534 | Sushila M Mathew | Pediatrics | 193 N Park Trl, Ste 100, Stockbridge, GA 30281-7373 | 2006-06-06 |
| 1366499634 | Marixie Q Leonor-gilrane | Pediatrics | 239 Village Center Pkwy, Suite 110, Stockbridge, GA 30281-9024 | 2006-05-30 |
| 1730162702 | Candace J Johnson | Pediatrics | 290 Country Club Dr Ste 140, Stockbridge, GA 30281-9094 | 2005-11-23 |
| 1417958281 | Juan Jose Sherwood | Pediatrics | 150 Medical Blvd, Suite B, Stockbridge, GA 30281-5053 | 2005-08-03 |
| 1902806508 | Ravi S Iyer | Pediatrics | 3579 Highway 138, Suite 103, Stockbridge, GA 30281-4142 | 2005-07-26 |
| 1477966380 | Cj Pediatrics LLC | Pediatrics | 290 Country Club Dr, 140, Stockbridge, GA 30281 | 2014-06-09 |
| Find all providers in STOCKBRIDGE | ||||
| City | STOCKBRIDGE |
| Zip Code | 30281 |
Please comment or provide details below to improve the information on SOUTHSIDE PEDIATRICS.
| 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.