NPIMap

Organization Active NPI

Braselton Pediatrics, PC

  • Medical Specialty Clinic/Center
  • Hoschton, GA
National Provider Identifier
1194974907
Registry record updated Sep 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
BRASELTON PEDIATRICS, PC
Practice address
1897 Highway 211 NW
Suite 100
Hoschton, GA 30548
Phone
(678) 820-7979
Fax
(678) 820-7980
NPI assigned
Sep 17, 2008
Last updated
Sep 17, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2008

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

Authorized official

Name
Marc-Yriane Borieux, M.D.NPI 1700095742
Title
President
Phone
(419) 787-8685

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
Medical Specialty Clinic/Center 261QM2500X GA Primary

Addresses

Primary practice location

1897 Highway 211 NW
Suite 100
Hoschton, GA 30548

Mailing address

1651 Tailmore LN
Lawrenceville, GA 30043-7862
Phone (678) 820-7979

Other identifiers 2

IdentifierTypeStateIssuer
059604OtherSTATE OF GEORGIA MEDICAL LICENSE
1700095742OtherGANPI

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1832/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 4

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": "1221609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221609600000",
    "number": "1194974907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1651 TAILMORE LN",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300437862",
            "telephone_number": "678-820-7979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1897 HIGHWAY 211 NW",
            "address_2": "SUITE 100",
            "city": "HOSCHTON",
            "state": "GA",
            "postal_code": "30548",
            "telephone_number": "678-820-7979",
            "fax_number": "678-820-7980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRASELTON PEDIATRICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-17",
        "last_updated": "2008-09-17",
        "status": "A",
        "authorized_official_last_name": "BORIEUX",
        "authorized_official_first_name": "MARC-YRIANE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "419-787-8685",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF GEORGIA MEDICAL LICENSE",
            "identifier": "059604",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1700095742",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoschton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2008; 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.