Individual provider Active NPI

Michael Patterson, MD

  • Pediatrics Physician
  • Cumming, GA
National Provider Identifier
1053475970
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
38328 Issued in GA
Practice address
410 Peachtree Pkwy
Suite 300
Cumming, GA 30041-7066
Phone
(404) 785-3020
Fax
(404) 785-3033
NPI assigned
Dec 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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 38328 GA Primary

Addresses

Primary practice location

410 Peachtree Pkwy
Suite 300
Cumming, GA 30041-7066

Mailing address

410 Peachtree Pkwy
Suite 300
Cumming, GA 30041-7066
Phone (404) 785-3020

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address choa@choa.gadirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160603000540 GA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 6709176704

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
38328GAMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1053475970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 PEACHTREE PKWY",
            "address_2": "SUITE 300",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300417066",
            "telephone_number": "404-785-3020",
            "fax_number": "404-785-3033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 PEACHTREE PKWY",
            "address_2": "SUITE 300",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300417066",
            "telephone_number": "404-785-3020",
            "fax_number": "404-785-3033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-22",
        "last_updated": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "38328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "choa@choa.gadirect.net",
            "affiliation": "N",
            "address_1": "410 Peachtree Pkwy",
            "address_2": "Suite 300",
            "city": "Cumming",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300417066",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

Verify at the official NPI Registry.