NPIMap

Organization Active NPI

Dahlonega Pediatric & Adolescent Medicine, Inc.

  • Pediatric Clinical Nurse Specialist
  • Dahlonega, GA
National Provider Identifier
1376096321
Registry record updated Jul 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Clinical Nurse SpecialistTaxonomy code 364SP0200X
License
1639298458 Issued in GA
Legal business name
DAHLONEGA PEDIATRIC & ADOLESCENT MEDICINE, INC.
Practice address
1055 Grove St N
Dahlonega, GA 30533-3876
Phone
(706) 864-6700
NPI assigned
Jul 26, 2016
Last updated
Jul 26, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2016

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

Authorized official

Name
Margaret Payne, RNCS, MN, PNPNPI 1639298458
Title
Nurse Practitioner/Owner
Phone
(706) 864-6700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Clinical Nurse Specialist 364SP0200X 1639298458 GA Primary

Addresses

Primary practice location

1055 Grove St N
Dahlonega, GA 30533-3876

Mailing address

1055 Grove St N
Dahlonega, GA 30533-3876
Phone (706) 864-6700

Other identifiers 1

IdentifierTypeStateIssuer
000489189SMedicaidGA

National Provider Directory

National Provider Directory
Tax ID family
Dahlonega Pediatric Adolescent Medicine4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1469491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469491200000",
    "number": "1376096321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 GROVE ST N",
            "city": "DAHLONEGA",
            "state": "GA",
            "postal_code": "305333876",
            "telephone_number": "706-864-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 GROVE ST N",
            "city": "DAHLONEGA",
            "state": "GA",
            "postal_code": "305333876",
            "telephone_number": "706-864-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAHLONEGA PEDIATRIC & ADOLESCENT MEDICINE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-26",
        "last_updated": "2016-07-26",
        "status": "A",
        "authorized_official_last_name": "PAYNE",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_title_or_position": "NURSE PRACTITIONER/OWNER",
        "authorized_official_telephone_number": "706-864-6700",
        "authorized_official_credential": "RNCS, MN, PNP"
    },
    "taxonomies": [
        {
            "code": "364SP0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Pediatrics",
            "state": "GA",
            "license": "1639298458",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000489189S",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dahlonega, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2016; 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.