Individual provider Active NPI

Catherine C Dragstedt, MD

  • Pediatrics Physician
  • Duluth, GA
National Provider Identifier
1336207562
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
032376 Issued in GA
Practice address
3650 Steve Reynolds Boul
Pediatrics Health Care Team a
Duluth, GA 30096
Phone
(770) 931-6012
NPI assigned
Dec 4, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 032376 GA Primary

Addresses

Primary practice location

3650 Steve Reynolds Boul
Pediatrics Health Care Team a
Duluth, GA 30096

Mailing address

3495 Piedmont Road NE
Nine Piedmont Center
Atlanta, GA 30305
Phone (404) 364-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041229000497 GA Practitioner - Pediatric Medicine 7315905999 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
The Southeast Permanente Medical Group Pediatrics CurrentSince Dec 8, 2010 Accepting new patients

Locations

3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000

3650 Steve Reynolds Blvd
#A
Duluth, GA 30096
Phone (770) 931-6011

3650 Steve Reynolds Blvd
Duluth, GA 30096
Phone (770) 931-6010

Organizations & group practices 1

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": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336207562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 PIEDMONT ROAD NE",
            "address_2": "NINE PIEDMONT CENTER",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30305",
            "telephone_number": "404-364-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 STEVE REYNOLDS BOUL",
            "address_2": "PEDIATRICS HEALTH CARE TEAM A",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "30096",
            "telephone_number": "770-931-6012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAGSTEDT",
        "first_name": "CATHERINE",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "032376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

Verify at the official NPI Registry.