Organization Active NPI

Bi-County Pediatrics

  • Pediatrics Physician
  • Douglasville, GA
National Provider Identifier
1366569485
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
058682 Issued in GA
Legal business name
BI-COUNTY PEDIATRICS
Practice address
6128 Prestley Mill Rd Ste D
Douglasville, GA 30134-5622
Phone
(770) 949-3888
Fax
(770) 949-3504
NPI assigned
Mar 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Raymond P Flowers III, D.O.NPI 1780675710
Title
Owner
Phone
(770) 949-3888

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208000000X 020701 GA
Pediatrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208000000X 058682 GA Primary

Addresses

Primary practice location

6128 Prestley Mill Rd Ste D
Douglasville, GA 30134-5622

Mailing address

6128 Prestley Mill Rd Ste D
Douglasville, GA 30134-5622
Phone (770) 949-3888

Other identifiers 1

IdentifierTypeStateIssuer
30022158CMedicaidGA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D0256502Bi-County Pediatrics6128D Prestley Mill Rd, Douglasville, GA 30134Certificate of waiverMay 25, 2027

National Provider Directory

National Provider Directory

Locations

6128 Prestley Mill Rd
Ste D
Douglasville, GA 30134
Phone (770) 949-3888

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": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366569485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6128 PRESTLEY MILL RD STE D",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301345622",
            "telephone_number": "770-949-3888",
            "fax_number": "770-949-3504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6128 PRESTLEY MILL RD STE D",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301345622",
            "telephone_number": "770-949-3888",
            "fax_number": "770-949-3504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BI-COUNTY PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FLOWERS",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-949-3888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "020701",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "058682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30022158C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglasville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.