Joan Ifarinde, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

062122 Issued in GA

Practice address

3075 Ronald Reagan Blvd
Suite 501
Cumming, GA 30041-6052

Phone

(678) 736-6000

Fax

(678) 736-6004

NPI assigned

Mar 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CEHGCA/Endpoint/CEHGCA

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483315200000",
    "number": "1124095021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4950",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300234950",
            "telephone_number": "678-736-6000",
            "fax_number": "678-736-6004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3075 RONALD REAGAN BLVD",
            "address_2": "SUITE 501",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300416052",
            "telephone_number": "678-736-6000",
            "fax_number": "678-736-6004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IFARINDE",
        "first_name": "JOAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-01",
        "last_updated": "2017-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "062122",
            "primary": true
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "GA",
            "license": "062122",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "GA",
            "license": "062122",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Preston Leigh Imhof, D.O.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.