Pediatrics at Whitlock P.C.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

047011 Issued in GA

Legal business name

PEDIATRICS AT WHITLOCK P.C.

Practice address

611 Campbell Hill St NW Ste 103
Marietta, GA 30060-1386

Phone

(770) 499-8909

Fax

(770) 499-8911

NPI assigned

May 15, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Lawrence Vincent Poold

Title

Office Manager

Phone

(770) 499-8909

Specialties & licenses 1

Addresses

Other identifiers 2

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/9593/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1210809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404691200000",
    "number": "1184891400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 CAMPBELL HILL ST NW STE 103",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601386",
            "telephone_number": "770-499-8909",
            "fax_number": "770-499-8911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 CAMPBELL HILL ST NW STE 103",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601386",
            "telephone_number": "770-499-8909",
            "fax_number": "770-499-8911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRICS AT WHITLOCK P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-15",
        "last_updated": "2014-07-07",
        "status": "A",
        "authorized_official_last_name": "POOLD",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "VINCENT",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "770-499-8909",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "GA",
            "license": "047011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. STEPHANIE L. POOLE'S NPI",
            "identifier": "1003983693",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000949044D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Pate Pecunia, MS, EDS, LPC
• Pediatric and Adolescent Healthcare,PC
• Pediatric Associates, PC
• Pediatric Smile Studio
• Pediatrics and Adolescent Medicine, PA
• Pediatrix Medical Group of Georgia, P.C.
• Tatiana Peduri
• Daniel Peeks, LAPC
• Kimberly Peery
• Kishwar Peiris, LPC

• Primary Care Clinic/Center in Marietta, GA
• Providers in Marietta, 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 Jul 7, 2014; 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.