Individual provider Active NPI

Nicki T Pesik, MD

  • Emergency Medicine Physician
  • Atlanta, GA
National Provider Identifier
1376554295
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
43742 Issued in GA
Practice address
531 Asbury Circle-Annex
Suite N340
Atlanta, GA 30322-0001
Phone
(404) 778-5975
Fax
(404) 778-2630
NPI assigned
Aug 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 43742 GA Primary

Addresses

Primary practice location

531 Asbury Circle-Annex
Suite N340
Atlanta, GA 30322-0001

Mailing address

531 Asbury Circle-Annex
Suite N340
Atlanta, GA 30322-0001
Phone (404) 778-5975

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
43742GAMDEmergency Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376554295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 ASBURY CIRCLE-ANNEX",
            "address_2": "SUITE N340",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303220001",
            "telephone_number": "404-778-5975",
            "fax_number": "404-778-2630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 ASBURY CIRCLE-ANNEX",
            "address_2": "SUITE N340",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303220001",
            "telephone_number": "404-778-5975",
            "fax_number": "404-778-2630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PESIK",
        "first_name": "NICKI",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "43742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.