NPIMap

Organization Active NPI

United Pediatrics PC

  • Pediatrics Physician
  • Norcross, GA
National Provider Identifier
1003119934
Registry record updated Dec 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
045783 Issued in GA
Legal business name
UNITED PEDIATRICS PC
Practice address
4775 Jimmy Carter Blvd
Suite 102
Norcross, GA 30093-3760
Phone
(770) 717-0033
Fax
(770) 717-0028
NPI assigned
Dec 15, 2010
Last updated
Dec 15, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Tayaba Fatema, MDNPI 1629027743
Title
Owner
Phone
(770) 717-0033

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 045783 GA Primary

Addresses

Primary practice location

4775 Jimmy Carter Blvd
Suite 102
Norcross, GA 30093-3760

Mailing address

4775 Jimmy Carter Blvd
Suite 102
Norcross, GA 30093-3760
Phone (770) 717-0033

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1292371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292371200000",
    "number": "1003119934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4775 JIMMY CARTER BLVD",
            "address_2": "SUITE 102",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300933760",
            "telephone_number": "770-717-0033",
            "fax_number": "770-717-0028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4775 JIMMY CARTER BLVD",
            "address_2": "SUITE 102",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300933760",
            "telephone_number": "770-717-0033",
            "fax_number": "770-717-0028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED PEDIATRICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-15",
        "last_updated": "2010-12-15",
        "status": "A",
        "authorized_official_last_name": "FATEMA",
        "authorized_official_first_name": "TAYABA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-717-0033",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "045783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norcross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.