Peach Blossom Pediatrics, LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

PEACH BLOSSOM PEDIATRICS, LLC

Doing business as

Peach Blossom Pediatrics

Practice address

1007 Weatherstone Pkwy Ste 210
Woodstock, GA 30188-4497

Phone

(470) 203-0006

NPI assigned

Jan 11, 2024

Organization subpart

No

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

Authorized official

Name

Whitney Fose, MDNPI 1194867713

Title

Owner

Phone

(470) 203-0006

Specialties & licenses 1

Addresses

Other names 1

• Peach Blossom Pediatrics Doing business as

Locations

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.

• Whitney Lauren Fose, MD

  • Pediatrics Physician
  • Woodstock, GA
  • NPI 1194867713
  NPD Authorized official

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

{
    "created_epoch": "1704931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704931200000",
    "number": "1053182733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 WEATHERSTONE PKWY STE 210",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301884497",
            "telephone_number": "470-203-0006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 WEATHERSTONE PKWY STE 210",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301884497",
            "telephone_number": "470-203-0006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACH BLOSSOM PEDIATRICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-11",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A",
        "authorized_official_last_name": "FOSE",
        "authorized_official_first_name": "WHITNEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "470-203-0006",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peach Blossom Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amy Lynn Patterson, APRN, FNP-C
• James Daniel Patterson, DDS
• David Patton, FAMILY NURSE PRACTIT
• Emily Elizabeth Patton
• Ann Marie Pauley
• Peach State Transitional Care LLC
• Dione Michelle Peach
• Peachtree Orthopaedic Clinic, PA
• Melissa Pealor, DC
• Danielle Alyssa Pecora, OTR/L

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2024; 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.