Active NPI
Fred A Tega, MD
- Pediatrics Physician
- Newnan, GA
National Provider Identifier
1043265259
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 056493
- Practice address
- 15 Baynard Park
Newnan, GA 30265-6413 - Phone
- (770) 251-5253
- Fax
- (770) 251-5254
- NPI assigned
- May 24, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 056493 | GA | Primary |
Addresses
Primary practice location
15 Baynard Park
Newnan, GA 30265-6413
Mailing address
15A Baynard Park
Newnan, GA 30265
Phone (770) 251-5253
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 860284415G | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056493 | GA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Primecare Pediatrics, P.C. | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pediatrics Physician
- Newnan, GA
- NPI 1396905907
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549670400000",
"number": "1043265259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15A BAYNARD PARK",
"city": "NEWNAN",
"state": "GA",
"postal_code": "30265",
"telephone_number": "770-251-5253",
"fax_number": "770-251-5254"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 BAYNARD PARK",
"city": "NEWNAN",
"state": "GA",
"postal_code": "302656413",
"telephone_number": "770-251-5253",
"fax_number": "770-251-5254"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEGA",
"first_name": "FRED",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-24",
"last_updated": "2019-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "GA",
"license": "056493",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "860284415G",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newnan, GA
- Adyson Leah Taylor
- Kenneth William Taylor, PHARMD.
- Lisa Taylor, DMD
- Jasmine Marie Teamer, MSN, AGACNP-BC
- Caroline Dean Teehan, BCBA
- Christie Tenney, CASE MANAGER
- Sharon Terry, RISGERTERED NURSE
- The Atlanta Cornea Care Center - Dr. Kenyatta Brantley, Optometrist (P.C.)
- The Center for Inclusive Recreation, LLC
- The Kroger Co
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.