PEDIATRIC PARTNERS LLC (NPI# 1972591238) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972591238 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC PARTNERS LLC |
| Practice Address |
1520b Jennings Mill Rd Bogart GA 30622-2543 |
| Practice Telephone | 7065481216 |
| Practice Fax Number | 7065481772 |
| Mailing Telephone | 7065481216 |
| Mailing Fax Number | 7065481772 |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DEBBIE L. EUBANKS (ADMINISTRATOR) |
| Authorized Official Telephone | 7065481216 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 85002970G | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639245277 | Pediatric Partners LLC | Pediatrics | 8765 W Kelton Ln Ste 116, Peoria, AZ 85382-5008 | 2006-11-27 |
| 1912043936 | Pediatric Partners LLC | Pediatrics | 8600 Lasalle Rd, Potomac Building Suite 105, Baltimore, MD 21286-2001 | 2007-01-29 |
| Street Address |
1520B JENNINGS MILL RD |
| City | BOGART |
| State | GA |
| Zip Code | 30622-2543 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457349714 | Ingrid Ruth Newman | Pediatrics | 1520b Jennings Mill Rd, Bogart, GA 30622-2543 | 2005-10-11 |
| 1508131905 | Natalie Spif Romines | Nurse Practitioner | 1520b Jennings Mill Rd, Bogart, GA 30622-2543 | 2012-03-19 |
| 1538157839 | Van Scott Mccorkle | Pediatrics | 1520b Jennings Mill Rd, Bogart, GA 30622-2543 | 2005-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780108266 | Catherine Colquitt | Specialist/Technologist | 1081 Rocky Branch Rd, Bogart, GA 30622 | 2017-07-27 |
| 1154864775 | Hampton Valley Health Center, Inc. | Chiropractor | 2881 Monroe Highway, Suite 701, Bogart, GA 30622 | 2016-11-30 |
| 1740298728 | Thomas W Mccormack Jr. | Psychiatry & Neurology | 1361 Jennings Mill Road, Building 200 Suite 201, Bogart, GA 30622 | 2006-08-04 |
| 1659308872 | Blue Laser Group | Ophthalmology | 1747 Langford Drive, Building 400, Suite 101, Bogart, GA 30622 | 2006-06-26 |
| 1225076821 | Pruitthealth Hospice, Inc. | Hospice Care, Community Based | 1751 Meriweather Dr, Bogart, GA 30622 | 2006-06-03 |
| 1205837374 | Terrance L Hughes | Specialist | 1500 Langford Medical Dr., Bldg 200, Bogart, GA 30622 | 2005-08-10 |
| 1922590892 | Inside Out Therapy Services | Occupational Therapist | 1450 Eden Ave, Bogart, GA 30622 | 2018-06-05 |
| 1144517038 | Gentry Broach Tolbert | Nurse Practitioner | 1500 Langford Medical Drive, Bldg 200, Bogart, GA 30622 | 2011-06-30 |
| 1083736961 | Edward J Fisher Jr Md Inc | Psychiatry & Neurology | 1361 Jennings Mill Rd, Bldg 200 Ste 201, Bogart, GA 30622 | 2007-04-04 |
| 1760504641 | Andrew Philip Heidesch | Marriage & Family Therapist | 1361 Jennings Mill Road, Suite 201, Bogart, GA 30622 | 2007-04-04 |
| Find all providers in zip 30622 | ||||
| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| 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) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457349714 | Ingrid Ruth Newman | Pediatrics | 1520b Jennings Mill Rd, Bogart, GA 30622-2543 | 2005-10-11 |
| 1538157839 | Van Scott Mccorkle | Pediatrics | 1520b Jennings Mill Rd, Bogart, GA 30622-2543 | 2005-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427616515 | Pedsnow LLC | Pediatrics | 863 W Oglethorpe Hwy Ste 220, Hinesville, GA 31313-4491 | 2019-06-03 |
| 1073885828 | Middle Georgia Pediatrics | Pediatrics | 1508 Hardeman Ave Ste B, Macon, GA 31201-1471 | 2012-02-08 |
| 1003184409 | Greer Gadsden Larned, M.d., P.C., Faap | Pediatrics | 3802 Waters Ave, Savannah, GA 31404-6210 | 2011-12-13 |
| 1427333095 | Dahlonega Pediatric and Adolescent Medicine | Pediatrics | 1055 North Grove St., Dahlonega, GA 30533 | 2011-10-14 |
| 1770710824 | Children's Medicine of Rockdale | Pediatrics | 1765 Parker Rd Se, Suite B210, Conyers, GA 30094-6652 | 2009-06-16 |
| 1518110451 | Pedia Doc Children's Med Ctr | Pediatrics | 3088 Campbellton Rd Sw, Atlanta, GA 30311-5410 | 2008-10-23 |
| 1396929444 | Total Grace Pediatrics P.C. | Pediatrics | 900 N Hairston Rd # Rs, Suite A, Stone Mountain, GA 30083-2857 | 2007-12-26 |
| 1306060801 | Crystal M Edds | Pediatrics | 125b Victory Dr, Swainsboro, GA 30401-3234 | 2007-04-13 |
| 1962523639 | William P Bristol | Pediatrics | 3300 Fourth Street, Brunswick, GA 31520-3779 | 2007-04-02 |
| 1861527103 | Florida Selga Basilio | Pediatrics | 1519 13th Ave, Columbus, GA 31901-1908 | 2007-02-23 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on PEDIATRIC PARTNERS LLC.
| 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.