NPIMap

Organization Active NPI

Children's Healthcare of Atlanta Marietta Primary Care

  • Clinic/Center
  • Marietta, GA
National Provider Identifier
1235161464
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
040933 Issued in GA
Legal business name
CHILDREN'S HEALTHCARE OF ATLANTA MARIETTA PRIMARY CARE
Practice address
895 Canton Rd NE BLDG 100
Marietta, GA 30060-8935
Phone
(404) 785-8220
Fax
(404) 785-8257
NPI assigned
Jul 7, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Janet Jung, MD
Title
Staff Pediatrican
Phone
(404) 785-8200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 040933 GA Primary

Addresses

Primary practice location

895 Canton Rd NE BLDG 100
Marietta, GA 30060-8935

Mailing address

895 Canton Rd NE BLDG 100
Marietta, GA 30060-8935
Phone (404) 785-8220

National Provider Directory

National Provider Directory
Tax ID family
Department of Navy National Naval Medical Center107 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 4

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235161464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "895 CANTON RD NE BLDG 100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300608935",
            "telephone_number": "404-785-8220",
            "fax_number": "404-785-8257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "895 CANTON RD NE BLDG 100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300608935",
            "telephone_number": "404-785-8220",
            "fax_number": "404-785-8257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S HEALTHCARE OF ATLANTA MARIETTA PRIMARY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JUNG",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "STAFF PEDIATRICAN",
        "authorized_official_telephone_number": "404-785-8200",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "GA",
            "license": "040933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.