Active NPI
Carol Pardue, PNP-PC
- Pediatric Nurse Practitioner
- Atlanta, GA
National Provider Identifier
1255926614
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- RN231408
- Practice address
- 1405 Clifton Rd NE
Atlanta, GA 30322-6046 - Phone
- (404) 785-5437
- NPI assigned
- Mar 7, 2021
- Last updated
- Jul 28, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | RN231408 | GA | Primary |
Addresses
Primary practice location
1405 Clifton Rd NE
Atlanta, GA 30322-6046
Mailing address
2452 Shadydale LN
Decatur, GA 30033-4824
Phone (706) 348-3896
Other practice location 1
1001 Johnson Fy Rd NE
Atlanta, GA 30342-1605
Phone (404) 785-5437
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN231408 | GA | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690502400000",
"number": "1255926614",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2452 SHADYDALE LN",
"city": "DECATUR",
"state": "GA",
"postal_code": "300334824",
"telephone_number": "706-348-3896"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1405 CLIFTON RD NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303226046",
"telephone_number": "404-785-5437"
}
],
"practiceLocations": [
{
"address_1": "1001 Johnson Fy Rd NE",
"address_purpose": "LOCATION",
"city": "Atlanta",
"state": "GA",
"postal_code": "303421605",
"country_code": "US",
"telephone_number": "404-785-5437",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PARDUE",
"first_name": "CAROL",
"credential": "PNP-PC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-03-07",
"last_updated": "2023-07-28",
"certification_date": "2023-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Pediatrics",
"state": "GA",
"license": "RN231408",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.