Middle Georgia Pediatrics

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

048846 Issued in GA

Legal business name

MIDDLE GEORGIA PEDIATRICS

Practice address

1508 Hardeman Ave Ste B
Macon, GA 31201-1471

Phone

(478) 741-7371

Fax

(478) 741-7372

NPI assigned

Feb 8, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Stanley Seth Bush, M.D.NPI 1578500591

Title

Proprietor

Phone

(478) 741-7371

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stanley Seth Bush III, M.D.

  • Pediatrics Physician
  • Macon, GA
  • NPI 1578500591
  NPD (past) Authorized official
• Dana Lindsey Mayo, MD

  • Pediatrics Physician
  • Macon, GA
  • NPI 1093043267
  NPD (past)
• Jennifer Johnson Slade, CPNP-PC

  • Pediatric Nurse Practitioner
  • Macon, GA
  • NPI 1013147503
  NPD (past)

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

{
    "created_epoch": "1328659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328659200000",
    "number": "1073885828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1508 HARDEMAN AVE STE B",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312011471",
            "telephone_number": "478-741-7371",
            "fax_number": "478-741-7372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1508 HARDEMAN AVE STE B",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312011471",
            "telephone_number": "478-741-7371",
            "fax_number": "478-741-7372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLE GEORGIA PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-08",
        "last_updated": "2012-02-08",
        "status": "A",
        "authorized_official_last_name": "BUSH",
        "authorized_official_first_name": "STANLEY",
        "authorized_official_middle_name": "SETH",
        "authorized_official_title_or_position": "PROPRIETOR",
        "authorized_official_telephone_number": "478-741-7371",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "GA",
            "license": "048846",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000872737B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Middle Georgia Gastroenterology
• Middle Georgia Heart and Vascular Center, LLC
• Middle Georgia Heart Rhythm Specialists, LLC
• Middle Georgia Internal Medicine & Kidney Diseases
• Middle Georgia Life Care Inc.
• Middle Georgia Pediatrics
• Middle Georgia Regional Commission
• Middle Georgia Sleep & Wellness Center LLC
• Middle Georgia Wound Solutions LLC
• Middle Moodycare Inc

• Pediatric Adolescent Medicine Physician in Macon, GA
• Providers in Macon, GA by specialty
• Pediatric Adolescent Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2012; 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.