NPIMap

Organization Active NPI

Pediatrics at Brookstone Centre, PC

  • Pediatrics Physician
  • Columbus, GA
National Provider Identifier
1215989462
Registry record updated Feb 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
79092 Issued in GA
Legal business name
PEDIATRICS AT BROOKSTONE CENTRE, PC
Practice address
2001 Brookstone Centre Pkwy
Columbus, GA 31904-4572
Phone
(706) 571-9699
Fax
(706) 571-9565
NPI assigned
May 16, 2006
Last updated
Feb 19, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2018

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

Authorized official

Name
Neha Potini, MDNPI 1285933051
Title
Physician
Phone
(706) 571-9699

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 PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 79092 GA Primary

Addresses

Primary practice location

2001 Brookstone Centre Pkwy
Columbus, GA 31904-4572

Mailing address

2001 Brookstone Centre Pkwy
Columbus, GA 31904-4572
Phone (706) 571-9699

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D0996848Pediatrics at Brookstone Centre, PC2001 Brookstone Centre Parkway, Columbus, GA 31904Certificate of waiverMar 28, 2027

National Provider Directory

National Provider Directory

Locations

2001 Brookstone Centre Pkwy
Columbus, GA 31904
Phone (706) 571-9699

Practitioners & affiliated clinicians

Practitioners 11

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": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518998400000",
    "number": "1215989462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BROOKSTONE CENTRE PKWY",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319044572",
            "telephone_number": "706-571-9699",
            "fax_number": "706-571-9565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 BROOKSTONE CENTRE PKWY",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319044572",
            "telephone_number": "706-571-9699",
            "fax_number": "706-571-9565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRICS AT BROOKSTONE CENTRE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2018-02-19",
        "status": "A",
        "authorized_official_last_name": "POTINI",
        "authorized_official_first_name": "NEHA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "706-571-9699",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "79092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.