Individual provider Active NPI

Aileen P O'Neill, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Conyers, GA
National Provider Identifier
1306815030
Registry record updated Sep 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
033597 Issued in GA
Practice address
3248 Avalon Blvd
Conyers, GA 30013-6320
Phone
(770) 922-9706
Fax
(770) 922-8792
NPI assigned
Mar 15, 2006
Last updated
Sep 7, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 033597 GA Primary

Addresses

Primary practice location

3248 Avalon Blvd
Conyers, GA 30013-6320

Mailing address

3248 Avalon Blvd
Conyers, GA 30013-6320
Phone (770) 922-9706

Other identifiers 1

IdentifierTypeStateIssuer
00544409EMedicaidGA

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)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Pathology and Laboratory Medicine, PC Anatomic Pathology & Clinical Pathology Past Accepting new patients
Rockdale Pathology, PC Anatomic Pathology & Clinical Pathology PastSince Sep 11, 2001 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283817600000",
    "number": "1306815030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3248 AVALON BLVD",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300136320",
            "telephone_number": "770-922-9706",
            "fax_number": "770-922-8792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3248 AVALON BLVD",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300136320",
            "telephone_number": "770-922-9706",
            "fax_number": "770-922-8792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'NEILL",
        "first_name": "AILEEN",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-15",
        "last_updated": "2010-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "GA",
            "license": "033597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00544409E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2010; 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.