NPIMap

Organization Active NPI

Pediatric Neurology and Epilepsy Center

  • Neurology with Special Qualifications in Child Neurology Physician
  • Lawrenceville, GA
National Provider Identifier
1346510013
Registry record updated Jan 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
38271 Issued in GA
Legal business name
PEDIATRIC NEUROLOGY AND EPILEPSY CENTER
Practice address
170 Camden Hill Rd
A
Lawrenceville, GA 30046-7418
Phone
(770) 596-4631
Fax
(678) 990-8019
NPI assigned
Jan 11, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2012

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

Authorized official

Name
Dr. Aijaz A Khalid, M.D.NPI 1093884355
Title
Physician
Phone
(770) 596-4631

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0402X 38271 GA Primary

Addresses

Primary practice location

170 Camden Hill Rd
A
Lawrenceville, GA 30046-7418

Mailing address

170 Camden Hill Rd
Suite a
Lawrenceville, GA 30046-7418
Phone (770) 596-4631

Other identifiers 1

IdentifierTypeStateIssuer
602609808AMedicaidGA

National Provider Directory

National Provider Directory

Locations

170 Camden Hill Rd
Ste A
Lawrenceville, GA 30046
Phone (678) 990-8015

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1326240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326240000000",
    "number": "1346510013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 CAMDEN HILL RD",
            "address_2": "SUITE A",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300467418",
            "telephone_number": "770-596-4631",
            "fax_number": "678-990-8019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 CAMDEN HILL RD",
            "address_2": "A",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300467418",
            "telephone_number": "770-596-4631",
            "fax_number": "678-990-8019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC NEUROLOGY AND EPILEPSY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-11",
        "last_updated": "2012-01-11",
        "status": "A",
        "authorized_official_last_name": "KHALID",
        "authorized_official_first_name": "AIJAZ",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "770-596-4631",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "GA",
            "license": "38271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "602609808A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2012; 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.