Valentine Pediatric Group, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

VALENTINE PEDIATRIC GROUP, LLC

Practice address

2680 Lawrenceville Hwy Ste 100
Decatur, GA 30033-2526

Phone

(770) 285-7632

NPI assigned

Apr 30, 2021

Organization subpart

No

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

Authorized official

Name

Jenna Slaughter Davis, MDNPI 1174904148

Title

Ceo

Phone

(248) 240-0988

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

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

• Jenna Slaughter Davis, MD

  • Pediatrics Physician
  • Decatur, GA
  • NPI 1174904148
  NPD Authorized official

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

{
    "created_epoch": "1619740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628121600000",
    "number": "1154904878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2680 LAWRENCEVILLE HWY STE 100",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300332526",
            "telephone_number": "770-515-9898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2680 LAWRENCEVILLE HWY STE 100",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300332526",
            "telephone_number": "770-285-7632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALENTINE PEDIATRIC GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-30",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "JENNA",
        "authorized_official_middle_name": "SLAUGHTER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "248-240-0988",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "80692",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• VA Medical Center
• Prathyusha Vadlamani, DDS
• Rima Nitinchandra Vaidya, FNP
• Luis Felipe Valdes, PH.D.
• Sandra J. Valenciano, MD, MPH
• Samantha Wisner Valentini, RN
• Elizabeth Natalie Valera, LPC
• Samantha Maria Valeriano
• Sherena R Valico, RN
• Valorwell Living Care LLC

• Primary Care Clinic/Center in Decatur, GA
• Providers in Decatur, GA by specialty
• Primary Care Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.