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Organization Active NPI

Scottish Rite Children's Medical Center

Doing business as Children's Healthcare of Atlanta at Scottish Rite

  • Pediatric Hematology & Oncology Physician
  • Atlanta, GA
National Provider Identifier
1184779332
Registry record updated Oct 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
Legal business name
SCOTTISH RITE CHILDREN'S MEDICAL CENTER
Doing business as
Children's Healthcare of Atlanta at Scottish Rite
Practice address
1001 Johnson Ferry Rd NE
Atlanta, GA 30342-1605
Phone
(404) 785-5252
NPI assigned
Jan 25, 2007
Last updated
Oct 17, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2025

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

Authorized official

Name
Ruth Fowler
Title
Chief Financial Officer
Phone
(404) 785-5437

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X NU
Clinical Neuropsychologist 103G00000X NU
Dentist 122300000X NU
Pediatric Dentistry 1223P0221X NU
Pediatric Pathology Physician 207ZP0213X NU
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X NU
Pediatric Hematology & Oncology Physician 2080P0207X NU Primary
Pediatric Rehabilitation Medicine Physician 2081P0010X NU
Child & Adolescent Psychiatry Physician 2084P0804X NU
Hospitalist Physician 208M00000X NU

Addresses

Primary practice location

1001 Johnson Ferry Rd NE
Atlanta, GA 30342-1605

Mailing address

1575 Northeast Expy NE
Brookhaven, GA 30329-2401

Other names 1

  • Children's Healthcare of Atlanta at Scottish Rite Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040123000663 GA Part B Supplier - Clinic/Group Practice 4981506581 Receives reassigned benefits from 9 practitioners
Practice locations: Atlanta, GA; Decatur, GA; Duluth, GA; Fayetteville, GA; Lawrenceville, GA; Marietta, GA; Snellville, GA; Athens, GA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Scottish Rite Children's Medical Center11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations (25 of 28)

3155 North Point Pkwy
Bldg A
Alpharetta, GA 30005
Phone (404) 785-7226

1400 Tullie Rd NE
Fl 1
Atlanta, GA 30329
Phone (404) 785-1491

1400 Tullie Rd NE
Fl 6
Atlanta, GA 30329

1605 Chantilly Dr NE
Ste 200
Atlanta, GA 30324
Phone (404) 785-8180

1605 Chantilly Dr NE
Ste 201
Atlanta, GA 30324
Phone (404) 785-8421

2174 N Druid Hills Rd NE
Ste 3006
Atlanta, GA 30329

2174 N Druid Hills Rd NE
Ste 610
Atlanta, GA 30329

1554 Riverstone Pkwy
Ste 160
Canton, GA 30114
Phone (404) 785-4268

2270 Duluth Highway 120
Ste 200
Duluth, GA 30097
Phone (404) 785-8387

2600 Satellite Blvd
Duluth, GA 30096
Phone (404) 785-8110

2660 Satellite Blvd
#100
Duluth, GA 30096
Phone (404) 785-8590

1445 Mount Vernon Rd
Dunwoody, GA 30338
Phone (770) 280-1210

605 Big Shanty Rd NW
Ste 100
Kennesaw, GA 30144
Phone (404) 785-3229

4850 Sugarloaf Pkwy
Ste 702
Lawrenceville, GA 30044
Phone (678) 442-7946

3618 Sandy Plains Rd
Ste 100
Marietta, GA 30066
Phone (404) 785-8316

5600 W Jones Bridge Rd
Norcross, GA 30092
Phone (770) 246-9622

5445 Meridian Mark Rd
Ste 290
Sandy Springs, GA 30342
Phone (404) 785-5699

5455 Meridian Mark Rd
Sandy Springs, GA 30342
Phone (404) 591-1884

5455 Meridian Mark Rd
Ste 520
Sandy Springs, GA 30342
Phone (404) 785-4275

5461 Meridian Mark Rd
Ste 300
Sandy Springs, GA 30342
Phone (404) 727-5002

5461 Meridian Mark Rd
Ste 500
Sandy Springs, GA 30342
Phone (404) 785-3240

975 Johnson Fy Rd NE
Ste 350
Sandy Springs, GA 30342
Phone (404) 785-2003

993 Johnson Ferry Rd
Ste 260B
Sandy Springs, GA 30342
Phone (404) 785-4908

993 Johnson Fy Rd NE
Ste 260
Sandy Springs, GA 30342
Phone (404) 785-3300

1675 Cumberland Pkwy SE
Ste 305
Smyrna, GA 30080
Phone (404) 785-4271

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Children's Healthcare of Atlanta at Scottish RiteAtlanta, GA, CCN 113301 Hospital Operational/Managerial Control (100%) May 18, 2015

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 227

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.

View all 227

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760659200000",
    "number": "1184779332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1575 NORTHEAST EXPY NE",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303292401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 JOHNSON FERRY RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421605",
            "telephone_number": "404-785-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTTISH RITE CHILDREN'S MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "status": "A",
        "authorized_official_last_name": "FOWLER",
        "authorized_official_first_name": "RUTH",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "404-785-5437"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0213X",
            "taxonomy_group": "",
            "desc": "Pathology, Pediatric Pathology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2081P0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Children's Healthcare of Atlanta at Scottish Rite",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Children's Healthcare of Atlanta at Scottish Rite",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.