Atlanta Pediatric Healthcare, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

ATLANTA PEDIATRIC HEALTHCARE, LLC

Practice address

320 Lanier Ave W Ste 259
Fayetteville, GA 30214-1600

Phone

(770) 250-7477

NPI assigned

Sep 26, 2019

Last updated

Oct 30, 2022By 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

Priscella GrantNPI 1134840986

Title

Owner

Phone

(678) 431-5483

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Priscella Grant

  • Home Health Agency
  • Fayetteville, GA
  • NPI 1134840986
  NPD Authorized official

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

{
    "created_epoch": "1569456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667088000000",
    "number": "1174174445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 LANIER AVE W STE 259",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 LANIER AVE W STE 259",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141600",
            "telephone_number": "770-250-7477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTA PEDIATRIC HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-26",
        "last_updated": "2022-10-30",
        "certification_date": "2022-10-30",
        "status": "A",
        "authorized_official_last_name": "GRANT",
        "authorized_official_first_name": "PRISCELLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-431-5483"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003227891A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Home Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2022; 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.