Active NPI
Melissa J Perrin-Hernandez, M.D.
- Pediatrics Physician
- Ellenwood, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 83975
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD19062 | HI | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aylo Health, LLC | Current | Accepting new patients | |
| Aylo Health, LLC | Current | 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
- 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.
-
- Family Medicine Physician
- Atlanta, GA
- NPI 1013018811
-
- Family Medicine Physician
- Conyers, GA
- NPI 1144483744
-
- Diagnostic Radiology Physician
- Locust Grove, GA
- NPI 1194433219
-
- Family Medicine Physician
- Ellenwood, GA
- NPI 1447290218
-
- Family Medicine Physician
- Locust Grove, GA
- NPI 1710929914
-
- Sleep Medicine (Family Medicine) Physician
- Stockbridge, GA
- NPI 1922831445
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.