NPIMap

Organization Active NPI

Tri-County Pediatrics

  • Pediatrics Physician
  • Riverdale, GA
National Provider Identifier
1285859413
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
TRI-COUNTY PEDIATRICS
Practice address
808 Commerce Blvd
Suite a
Riverdale, GA 30296-7192
Phone
(770) 996-9191
NPI assigned
Apr 14, 2007
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
Mrs. Purna Chadalawada, M.D.NPI 1770532624
Title
Partner
Phone
(770) 996-9191

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

808 Commerce Blvd
Suite a
Riverdale, GA 30296-7192

Mailing address

808 Commerce Blvd
Suite a
Riverdale, GA 30296-7192
Phone (770) 996-9191

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
11D0258312Tri County Pediatrics808 Commerce Boulevard, Suite a, Riverdale, GA 30296Provider-performed microscopyJun 7, 2027

National Provider Directory

National Provider Directory
Tax ID family
Tri County Pediatrics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1240 Highway 54 W
Ste 100
Fayetteville, GA 30214
Phone (678) 817-4695

808 Commerce Blvd
Ste A
Riverdale, GA 30296
Phone (770) 996-9191

Practitioners & affiliated clinicians

Practitioners 10

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": "1176508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285859413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 COMMERCE BLVD",
            "address_2": "SUITE A",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302967192",
            "telephone_number": "770-996-9191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 COMMERCE BLVD",
            "address_2": "SUITE A",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302967192",
            "telephone_number": "770-996-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-COUNTY PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHADALAWADA",
        "authorized_official_first_name": "PURNA",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "770-996-9191",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverdale, 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.
  • 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.