NPIMap

Organization Active NPI

Jydes Family Clinic LLC

  • Child & Adolescent Psychiatry Physician
  • Norcross, GA
National Provider Identifier
1275840944
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
Legal business name
JYDES FAMILY CLINIC LLC
Practice address
4720 Peachtree Industrial Blvd
Suite 4101
Norcross, GA 30071-5735
Phone
(770) 686-3232
Fax
(770) 686-3233
NPI assigned
Sep 1, 2010
Last updated
Oct 9, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2025

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

Authorized official

Name
Haolat Abiola Babalakin, M.D.NPI 1245337708
Title
Ceo/Owner
Phone
(678) 466-7342

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0804X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

4720 Peachtree Industrial Blvd
Suite 4101
Norcross, GA 30071-5735

Mailing address

5805 State Bridge Rd Ste G-106
Johns Creek, GA 30097-8220
Phone (770) 903-4665

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110121000051 GA Part B Supplier - Clinic/Group Practice 9739368838 Receives reassigned benefits from 2 practitioners
Practice locations: Alpharetta, GA; Dacula, GA; Dawsonville, GA; Norcross, GA

National Provider Directory

National Provider Directory

Locations

3550 Old Milton Pkwy
Alpharetta, GA 30005
Phone (770) 674-0543

3966 S Bogan Rd
Buford, GA 30519
Phone (678) 765-8276

3966 S Bogan Rd
Bldg C
Buford, GA 30519

2089 Teron Trce
Ste 225
Dacula, GA 30019
Phone (678) 804-9944

5805 State Bridge Rd
Ste G106
Johns Creek, GA 30097

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1283299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759968000000",
    "number": "1275840944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5805 STATE BRIDGE RD STE G-106",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300978220",
            "telephone_number": "770-903-4665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4720 PEACHTREE INDUSTRIAL BLVD",
            "address_2": "SUITE 4101",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300715735",
            "telephone_number": "770-686-3232",
            "fax_number": "770-686-3233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JYDES FAMILY CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-01",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A",
        "authorized_official_last_name": "BABALAKIN",
        "authorized_official_first_name": "HAOLAT",
        "authorized_official_middle_name": "ABIOLA",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "678-466-7342",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norcross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.