Mohamed Midani, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

019080 Issued in GA

Practice address

145 N Medical Pkwy
Woodstock, GA 30189-7031

Phone

(770) 517-1900

NPI assigned

Oct 20, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wellstar Cornerstone Family Medicine, LLC

  • Family Medicine Physician
  • Acworth, GA
  • NPI 1518912518
  NPD (past)

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570752000000",
    "number": "1295724383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2230 TOWNE LAKE PKWY",
            "address_2": "BUILDING 300, SUITE 100",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301895540",
            "telephone_number": "770-517-1900",
            "fax_number": "770-926-3215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 N MEDICAL PKWY",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301897031",
            "telephone_number": "770-517-1900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2230 Towne Lake Pkwy",
            "address_2": "Building 300, Suite 100",
            "address_purpose": "LOCATION",
            "city": "Woodstock",
            "state": "GA",
            "postal_code": "301895540",
            "country_code": "US",
            "telephone_number": "770-517-1900",
            "fax_number": "770-926-3215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIDANI",
        "first_name": "MOHAMED",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2019-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "019080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmidani7204@directwellstar.org",
            "affiliation": "N",
            "address_1": "145 N Medical Pkwy",
            "city": "Woodstock",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301897031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Raymond Mertel, PHARM D
• Michael F Pratt, MD, PC
• Stella Michael-Makri, PH.D., LPC
• James Michalski, LDO
• Microsure LLC
• Edmund Ryan Mierzejewski, D.C.
• Kiana Miles, RBT
• Mill Creek Clinic, LLC
• Mill Creek Urgent Care
• Gary Michael Miller, MD

• Pediatrics Physician in Woodstock, GA
• Providers in Woodstock, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2019; 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.