NPIMap

Organization Active NPI

Jonesboro Pediatrics

  • Pediatrics Physician
  • Jonesboro, GA
National Provider Identifier
1225296155
Registry record updated Mar 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
JONESBORO PEDIATRICS
Practice address
236 Arrowhead Blvd
Jonesboro, GA 30236-1106
Phone
(770) 478-9240
Fax
(770) 478-0318
NPI assigned
May 28, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2021

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

Authorized official

Name
Romeo R Moriles, MDNPI 1669438420
Title
Physician Owner
Phone
(770) 478-9240

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 Primary

Addresses

Primary practice location

236 Arrowhead Blvd
Jonesboro, GA 30236-1106

Mailing address

236 Arrowhead Blvd
Jonesboro, GA 30236-1106
Phone (770) 478-9240

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
11D0722293Jonesboro Pediatrics236 Arrowhead Blvd, Jonesboro, GA 30236Certificate of waiverMar 31, 2027

National Provider Directory

National Provider Directory

Locations

236 Arrowhead Blvd
Jonesboro, GA 30236
Phone (770) 478-9240

210 W Campground Rd
McDonough, GA 30253

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616716800000",
    "number": "1225296155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 ARROWHEAD BLVD",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302361106",
            "telephone_number": "770-478-9240",
            "fax_number": "770-478-0318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 ARROWHEAD BLVD",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302361106",
            "telephone_number": "770-478-9240",
            "fax_number": "770-478-0318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JONESBORO PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-28",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A",
        "authorized_official_last_name": "MORILES",
        "authorized_official_first_name": "ROMEO",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "770-478-9240",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2021; 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.