Organization Active NPI

Children's Medical Associates, LLC

  • Pediatrics Physician
  • Austell, GA
National Provider Identifier
1184908188
Registry record updated Oct 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
057184 Issued in GA
Legal business name
CHILDREN'S MEDICAL ASSOCIATES, LLC
Practice address
1680 Mulkey Rd
Suite E
Austell, GA 30106-1118
Phone
(770) 941-5107
Fax
(770) 944-1013
NPI assigned
Oct 10, 2011
Last updated
Oct 10, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2011

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

Authorized official

Name
Shelly-Ann Michela Salandy, M.D.NPI 1205826500
Title
Owner/ Pediatrician
Phone
(770) 941-5107

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 057184 GA Primary

Addresses

Primary practice location

1680 Mulkey Rd
Suite E
Austell, GA 30106-1118

Mailing address

1680 Mulkey Rd
Suite E
Austell, GA 30106-1118
Phone (770) 941-5107

Other identifiers 1

IdentifierTypeStateIssuer
440133094DMedicaidGA

National Provider Directory

National Provider Directory

Locations

127 Enterprise Path
Ste 401
Hiram, GA 30141
Phone (770) 222-6622

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1318204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318204800000",
    "number": "1184908188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1680 MULKEY RD",
            "address_2": "SUITE E",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061118",
            "telephone_number": "770-941-5107",
            "fax_number": "770-944-1013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 MULKEY RD",
            "address_2": "SUITE E",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061118",
            "telephone_number": "770-941-5107",
            "fax_number": "770-944-1013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S MEDICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-10",
        "last_updated": "2011-10-10",
        "status": "A",
        "authorized_official_last_name": "SALANDY",
        "authorized_official_first_name": "SHELLY-ANN",
        "authorized_official_middle_name": "MICHELA",
        "authorized_official_title_or_position": "OWNER/ PEDIATRICIAN",
        "authorized_official_telephone_number": "770-941-5107",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "057184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "440133094D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2011; 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.