Premier Pediatrics of Albany

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

063038 Issued in GA

Legal business name

PREMIER PEDIATRICS OF ALBANY

Practice address

1909 Aberdeen Rd
Suite 106
Albany, GA 31701-1393

Phone

(229) 432-7444

Fax

(229) 432-7445

NPI assigned

Apr 16, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Dennis A Twedt, D.O.

Title

Owner

Phone

(229) 423-7444

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1271376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271376000000",
    "number": "1164748075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 ABERDEEN RD",
            "address_2": "SUITE 106",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317011393",
            "telephone_number": "229-432-7444",
            "fax_number": "229-432-7445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 ABERDEEN RD",
            "address_2": "SUITE 106",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317011393",
            "telephone_number": "229-432-7444",
            "fax_number": "229-432-7445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PEDIATRICS OF ALBANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-16",
        "last_updated": "2010-04-16",
        "status": "A",
        "authorized_official_last_name": "TWEDT",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "229-423-7444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "063038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "743298007B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "920320381B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2010; 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.