Gwinnett Pediatrics & Adolescent Medicine

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

Last updated

Dec 19, 2016By the provider in NPPES

Organization subpart

No

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

Addresses

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

CLIA laboratory certificates

Locations

Interoperability endpoints

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

Practitioners 32

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.

• Eliza Mattson Antonowich, CPNP-PC

  • Pediatric Nurse Practitioner
  • Lawrenceville, GA
  • NPI 1639877954
  NPD (past)
• Laura Ashley Babcock, D.O

  • Pediatrics Physician
  • Lawrence, GA
  • NPI 1376869420
  NPD (past)
• Alana Meryll Bozeman, M.D.

  • Pediatrics Physician
  • Lawrenceville, GA
  • NPI 1760773022
  NPD (past)
• Amanda Lee Carlton, PNP

  • Pediatric Nurse Practitioner
  • Atlanta, GA
  • NPI 1386999613
  NPD (past)
• Scott Darby, M.D.

  • Pediatrics Physician
  • Lawrenceville, GA
  • NPI 1063851996
  NPD (past)
• Mahnaz Faroqui, M.D.

  • Pediatrics Physician
  • Lawrenceville, GA
  • NPI 1760748404
  NPD (past)
• Lauren Ashley Garmon, C.P.N.P.

  • Pediatric Nurse Practitioner
  • Lawrenceville, GA
  • NPI 1144528928
  NPD (past)
• Rachel Elizabeth Gillman, DO

  • Pediatrics Physician
  • Lawrenceville, GA
  • NPI 1447614656
  NPD (past)
• Nolan Gregory Graham, MD

  • Pediatrics Physician
  • Lawrenceville, GA
  • NPI 1487132353
  NPD (past)
• Hal M Herd, MD

  • Pediatrics Physician
  • Lawrenceville, GA
  • NPI 1841206240
  NPD (past)
• Sara Susan Jacobsen, M.D.

  • Pediatrics Physician
  • Lawrenceville, GA
  • NPI 1902196553
  NPD (past)
• John Wesley Johnson

  • Pediatrics Physician
  • Lawrenceville, GA
  • NPI 1972985356
  NPD (past)

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": []
}

• Gwinnett Operations, LLC (Life Care Center of Lawrenceville)
• Gwinnett Oral & Maxillofacial Surgery, PC
• Gwinnett Orthopedics PC (Atlanta Orthopedics)
• Gwinnett Pathology Assoc PC
• Gwinnett Pediactric Urgent Care
• Gwinnett Physician Group, LLC
• Gwinnett Podiatry Associates LLC
• Gwinnett Practice Solutions, LLC
• Gwinnett Psychiatry, P.C.
• Gwinnett Psychology, LLC

• Pediatrics Physician in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Pediatrics Physician in Georgia

• 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.