MCR Health, Inc.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

MCR HEALTH, INC.

Doing business as

Decatur Pediatric Group

Practice address

4112 E Ponce de Leon Ave
Clarkston, GA 30021-8106

Phone

(404) 296-7133

NPI assigned

May 31, 2022

Last updated

Jun 12, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Melvin B Price

Title

President & Ceo

Phone

(941) 776-4000

Specialties & licenses 4

Addresses

Other names 1

• Decatur Pediatric Group Doing business as

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

{
    "created_epoch": "1653955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686528000000",
    "number": "1104565910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 RIVERFRONT BLVD STE 710",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342058812",
            "telephone_number": "941-776-4000",
            "fax_number": "941-845-4963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4112 E PONCE DE LEON AVE",
            "city": "CLARKSTON",
            "state": "GA",
            "postal_code": "300218106",
            "telephone_number": "404-296-7133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCR HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-31",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A",
        "authorized_official_last_name": "PRICE",
        "authorized_official_first_name": "MELVIN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "941-776-4000"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Decatur Pediatric Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Decatur Pediatric Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; 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.