Individual provider Active NPI

Melissa J Perrin-Hernandez, M.D.

  • Pediatrics Physician
  • Ellenwood, GA
National Provider Identifier
1366736035
Registry record updated Sep 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
83975 Issued in GA
Practice address
211 Fairview Rd
Ellenwood, GA 30294-2721
Phone
(678) 289-6747
NPI assigned
May 31, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD19062 HI
Pediatrics Physician 208000000X 268303 NY
Pediatrics Physician 208000000X 83975 GA Primary

Addresses

Primary practice location

211 Fairview Rd
Ellenwood, GA 30294-2721

Mailing address

211 Fairview Rd
Ellenwood, GA 30294-2721
Phone (678) 289-6747

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
I20191112000406 GA Practitioner - Pediatric Medicine 2466678412 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD19062HIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aylo Health, LLC CurrentSince Sep 3, 2019 Accepting new patients
Aylo Health, LLC CurrentSince Sep 3, 2019 Accepting new patients
Aylo Health, LLC Current Accepting new patients
Aylo Health, LLC Past Accepting new patients
Aylo Health, LLC Past Accepting new patients
Aylo Health, LLC Past Accepting new patients

Locations

3333 Riverwood Pkwy SE
Ste 250
Atlanta, GA 30339
Phone (770) 914-0016

8111 Ball Ground Hwy
Ball Ground, GA 30107
Phone (770) 268-4011

3290 Sixes Rd
Canton, GA 30114
Phone (678) 374-7514

1101 Nortec Dr SE
Conyers, GA 30013
Phone (678) 374-7514

211 Fairview Rd
Ste 200
Ellenwood, GA 30294

211 Fairview Rd
Ellenwood, GA 30294
Phone (678) 289-6747

1058 Bear Creek Blvd
Hampton, GA 30228
Phone (770) 707-0808

1502 W 3rd St
Ste A
Jackson, GA 30233
Phone (678) 774-0430

2985 Mack Dobbs Rd NW
Kennesaw, GA 30152
Phone (770) 268-4011

3758 Highway 42 S
Locust Grove, GA 30248
Phone (678) 561-9430

50 Kelly Rd
Ste 200
McDonough, GA 30253
Phone (770) 957-1887

2330 Patrick Henry Pkwy
Ste 200
McDonough, GA 30253

65 Old Jackson Rd
McDonough, GA 30252
Phone (678) 490-0080

1240 Eagles Landing Pkwy
Ste 110
Stockbridge, GA 30281
Phone (770) 389-3855

145 Eagles Walk
Ste A
Stockbridge, GA 30281
Phone (770) 389-3855

1100 Hospital Dr
Stockbridge, GA 30281
Phone (678) 432-6161

Interoperability endpoints

  • Direct secure messaging: melissa.perrinhernandez@elfp.eclinicaldirectplus.com

Organizations & group practices 6

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": "1306800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567641600000",
    "number": "1366736035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 FAIRVIEW RD",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302942721",
            "telephone_number": "678-289-6747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 FAIRVIEW RD",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302942721",
            "telephone_number": "678-289-6747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRIN-HERNANDEZ",
        "first_name": "MELISSA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-31",
        "last_updated": "2019-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "HI",
            "license": "MD19062",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "268303",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "83975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellenwood, GA

Sources for this page

Verify at the official NPI Registry.