Pediatric Associates of Auburn

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

5738 Issued in AL

Legal business name

PEDIATRIC ASSOCIATES OF AUBURN

Practice address

2901 Corporate Park Dr
Opelika, AL 36801-7283

Phone

(334) 203-1766

Fax

(334) 203-1784

NPI assigned

Jan 18, 2007

Last updated

Jul 12, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Dianne Martinez Carlton

Title

Office Manager

Phone

(334) 203-1766

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• Richard M. Freeman, MD, PC Former legal business name

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 7

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.

• Victoria Grace Benes, DO

  • Pediatrics Physician
  • Opelika, AL
  • NPI 1326536210
  NPD
• Alexandrea Cool Jager, MD

  • Pediatrics Physician
  • Opelika, AL
  • NPI 1023684693

  Single Specialty

  NPD
• Katie Henderson Meadows, CPNP-PC

  • Pediatric Nurse Practitioner
  • Opelika, AL
  • NPI 1093332280
  NPD
• Gretchen Hillary Vandiver, MD

  • Pediatrics Physician
  • Opelika, AL
  • NPI 1386094811
  NPD
• Katie Ann Wolter, M.D.

  • Pediatrics Physician
  • Opelika, AL
  • NPI 1669793220
  NPD
• Matthew Brooke Lovato, M.D.

  • Pediatrics Physician
  • Gadsden, AL
  • NPI 1568424182
  NPD (past)
• Ayesha Mejia Nettles, MD

  • Pediatrics Physician
  • Fort Moore, GA
  • NPI 1871853226
  NPD (past)

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626048000000",
    "number": "1316099203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 CORPORATE PARK DRIVE",
            "city": "OPELIKA",
            "state": "AL",
            "postal_code": "368017283",
            "telephone_number": "334-203-1766",
            "fax_number": "334-203-1784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 CORPORATE PARK DR",
            "city": "OPELIKA",
            "state": "AL",
            "postal_code": "368017283",
            "telephone_number": "334-203-1766",
            "fax_number": "334-203-1784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ASSOCIATES OF AUBURN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A",
        "authorized_official_last_name": "CARLTON",
        "authorized_official_first_name": "DIANNE",
        "authorized_official_middle_name": "MARTINEZ",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "334-203-1766",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "AL",
            "license": "5738",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS RICHARD M. FREEMAN,",
            "identifier": "51002165",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000002165",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000044755",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ELLEN L. ROYAL, M.D.",
            "identifier": "51044755",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "528201420",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Richard M. Freeman, MD, PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Robert C Patton, M.D.
• Mallory Payne, OTR/L, ATC
• Marlena Grace Payne, LAT, ATC
• Bradley Wilson Peden, M.D.
• Jessica Leigh Pedersen, ARNP
• Pediatric Clinic LLC
• Pediatric Dentistry Associates, PC
• Perception Therapy LLC
• Melissa Jones Perry
• Sandra Edwards Perry

• Pediatric Adolescent Medicine Physician in Opelika, AL
• Providers in Opelika, AL by specialty
• Pediatric Adolescent Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2021; 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.