Patrick Neal Pulliam, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

050246 Issued in GA

Practice address

245 Country Club Dr BLDG 200a
Stockbridge, GA 30281-7212

Phone

(770) 389-4543

Fax

(770) 474-0566

NPI assigned

Aug 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ppulliam7495@choa.gadirect.net
• Direct secure messaging: drpulliam@covenantcarepeds.opdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Covenant Care Pediatrics PC

  • Pediatrics Physician
  • Stockbridge, GA
  • NPI 1902941503
  NPD Authorized official
• Piedmont Henry Hospital, Inc.

  • General Acute Care Hospital
  • Stockbridge, GA
  • NPI 1225034333
  NPD (past)

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696809600000",
    "number": "1215944863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 COUNTRY CLUB DR BLDG 200A",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817212",
            "telephone_number": "770-389-4543",
            "fax_number": "770-474-0566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 COUNTRY CLUB DR BLDG 200A",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817212",
            "telephone_number": "770-389-4543",
            "fax_number": "770-474-0566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULLIAM",
        "first_name": "PATRICK",
        "middle_name": "NEAL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "050246",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000909906C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Providence Hospice, Inc.
• Pruitthealth - Laurel Park, LLC
• Psychiatry Associates of Georgia PC
• Publix Super Markets Inc (Publix Pharmacy #0092)
• Publix Super Markets, Inc. (Publix Pharmacy #0547)
• Pulmonary & Sleep Medicine Associates, LLP
• Racquel Puranda, MD
• Saadia Qadeer
• Quality Diagnostic Health & Wellness
• Quality Diagnostic Health & Wellness

• Pediatrics Physician in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2023; 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.