Bob B Bagheri, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

040865 Issued in GA

Practice address

204 Canton Rd
Cumming, GA 30040-2304

Phone

(770) 886-5437

Fax

(770) 886-5437

NPI assigned

Mar 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Lakeside Pediatrics, LLC

  • Pediatrics Physician
  • Cumming, GA
  • NPI 1326317520
  NPD (past) Authorized official

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1326017906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11565 MOUNTAIN LAUREL DR",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300751333",
            "telephone_number": "770-886-5437",
            "fax_number": "770-886-9717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 CANTON RD",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300402304",
            "telephone_number": "770-886-5437",
            "fax_number": "770-886-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGHERI",
        "first_name": "BOB",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "040865",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00682107D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yunus O Ayodeji
• Baby Talk Therapies, Inc.
• Backsmart Health LLC - North Ga Diagnostic & Rehab
• Melissa Genevieve Baden, CACI
• Christal Bae, LAC.
• Shayan Bagheri, PA-C
• Sayed Bahaduri
• Felicity Dwamena Baidoo
• Jaymie Bailey, PA
• Shonda Shanel Bailey, AUD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.