NPIMap

Organization Active NPI

Gwinnett Pediatrics & Adolescent Medicine

  • Pediatrics Physician
  • Lawrenceville, GA
National Provider Identifier
1003940909
Registry record updated Dec 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
GWINNETT PEDIATRICS & ADOLESCENT MEDICINE
Practice address
595 Hurricane Shoals Rd NW
Suite 300
Lawrenceville, GA 30046
Phone
(770) 995-0823
Fax
(770) 995-7018
NPI assigned
Mar 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2016

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

Authorized official

Name
Mrs. Debbie Sue Maund
Title
Practice Administrator
Phone
(770) 995-0823

Specialties & licenses 1

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

Addresses

Primary practice location

595 Hurricane Shoals Rd NW
Suite 300
Lawrenceville, GA 30046

Mailing address

595 Hurricane Shoals Rd NW
Suite 300
Lawrenceville, GA 30046
Phone (770) 995-0823

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D0676735Gwinnett Pediatrics & Adolescent Medicine595 Hurricane Shoals Rd, NW, Lawrenceville, GA 30046ComplianceOct 12, 2027

National Provider Directory

National Provider Directory

Locations

2089 Teron Trce
Dacula, GA 30019

2089 Teron Trce
Ste 100
Dacula, GA 30019

3790 Pleasant Hill Rd
Ste 230
Duluth, GA 30096

601 Professional Dr
#A
Lawrenceville, GA 30046
Phone (404) 962-5552

595 Hurricane Shoals Rd NW
Ste 300
Lawrenceville, GA 30046
Phone (770) 995-0823

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14859/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 32

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482105600000",
    "number": "1003940909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "595 HURRICANE SHOALS RD NW",
            "address_2": "SUITE 300",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "30046",
            "telephone_number": "770-995-0823",
            "fax_number": "770-995-7018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 HURRICANE SHOALS RD NW",
            "address_2": "SUITE 300",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "30046",
            "telephone_number": "770-995-0823",
            "fax_number": "770-995-7018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GWINNETT PEDIATRICS & ADOLESCENT MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2016-12-19",
        "status": "A",
        "authorized_official_last_name": "MAUND",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "770-995-0823",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.