NPIMap

Organization Active NPI

Carrollton Pediatric Clinic, P.C.

Doing business as Westcare Pediatric and Family Care

  • Pediatrics Physician
  • Carrollton, GA
National Provider Identifier
1295834380
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
CARROLLTON PEDIATRIC CLINIC, P.C.
Doing business as
Westcare Pediatric and Family Care
Practice address
410 Newnan St
Carrollton, GA 30117-3111
Phone
(770) 832-1103
Fax
(770) 832-1142
NPI assigned
Sep 22, 2006
Last updated
Jun 21, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Authorized official

Name
Melissa Hall
Title
Office Manager
Phone
(770) 832-1103

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

410 Newnan St
Carrollton, GA 30117-3111

Mailing address

410 Newnan St
Carrollton, GA 30117-3111
Phone (770) 832-1103

Other identifiers 2

IdentifierTypeStateIssuer
300025719AMedicaidGA
11D0934505OtherGACLIA

Other names 1

  • Westcare Pediatric and Family Care Doing business as

National Provider Directory

National Provider Directory

Locations

410 Newnan St
Carrollton, GA 30117
Phone (770) 832-1103

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1295834380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 NEWNAN ST",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173111",
            "telephone_number": "770-832-1103",
            "fax_number": "770-832-1142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 NEWNAN ST",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173111",
            "telephone_number": "770-832-1103",
            "fax_number": "770-832-1142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARROLLTON PEDIATRIC CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "770-832-1103"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300025719A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "11D0934505",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Westcare Pediatric and Family Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Carrollton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.