Individual provider Active NPI

Arthur Gerald Reisman, MD

  • Pediatrics Physician
  • Dunwoody, GA
National Provider Identifier
1053352625
Registry record updated Aug 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
030421 Issued in GA
Practice address
1428 Dunwoody Village Pkwy
Dunwoody, GA 30338
Phone
(770) 394-2358
Fax
(770) 394-3055
NPI assigned
Jun 8, 2006
Last updated
Aug 18, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 030421 GA Primary

Addresses

Primary practice location

1428 Dunwoody Village Pkwy
Dunwoody, GA 30338

Mailing address

1428 Dunwoody Village Pkwy
Dunwoody, GA 30338
Phone (770) 394-2358

Other identifiers 1

IdentifierTypeStateIssuer
000377066MedicaidGA

Other names 1

  • Arthur Gerald Reisman Other name

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

LicenseStateTypeSpecialty
030421GAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dunwoody Pediatrics Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: areisman3445@choa.gadirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313625600000",
    "number": "1053352625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1428 DUNWOODY VILLAGE PKWY",
            "city": "DUNWOODY",
            "state": "GA",
            "postal_code": "30338",
            "telephone_number": "770-394-2358",
            "fax_number": "770-394-3055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1428 DUNWOODY VILLAGE PKWY",
            "city": "DUNWOODY",
            "state": "GA",
            "postal_code": "30338",
            "telephone_number": "770-394-2358",
            "fax_number": "770-394-3055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISMAN",
        "first_name": "ARTHUR",
        "middle_name": "GERALD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2011-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "030421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000377066",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ARTHUR",
            "last_name": "REISMAN",
            "middle_name": "GERALD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dunwoody, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2011; 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.