Golden Isles Pediatrics Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

050841 Issued in GA

Legal business name

GOLDEN ISLES PEDIATRICS INC

Practice address

1919 Glynn Ave
Suite 60
Brunswick, GA 31520-6176

Phone

(912) 265-4843

Fax

(912) 265-4869

NPI assigned

Aug 31, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Heather A Svenson, M.D.

Title

President

Phone

(912) 265-4843

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327881600000",
    "number": "1104938703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 GLYNN AVE",
            "address_2": "SUITE 60",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315206176",
            "telephone_number": "912-265-4843",
            "fax_number": "912-265-4869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 GLYNN AVE",
            "address_2": "SUITE 60",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315206176",
            "telephone_number": "912-265-4843",
            "fax_number": "912-265-4869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN ISLES PEDIATRICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2012-01-30",
        "status": "A",
        "authorized_official_last_name": "SVENSON",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "912-265-4843",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "050841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "699850421A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP PROVIDER #",
            "identifier": "10061954",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "336419",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE HEALTH PLAN",
            "identifier": "33619",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Golden Isles Foot Surgery Center
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• Golden Isles Palliative Care, Inc.
• Golden Isles Prosthetics & Avery Watson Strickland Sole MBR
• Golden Isles Psychiatric Associates, P.C.
• Golden Isles Treatment Center, Inc.
• Gina Golden, RN
• Bruce S. Goldin, O.D.

• Specialist in Brunswick, GA
• Providers in Brunswick, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.