NPIMap

Organization Active NPI

Primecare Pediatrics, P.C.

  • Pediatrics Physician
  • Newnan, GA
National Provider Identifier
1396905907
Registry record updated Feb 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PRIMECARE PEDIATRICS, P.C.
Practice address
15 Baynard Park
Newnan, GA 30265
Phone
(770) 251-5253
Fax
(770) 251-5254
NPI assigned
Jun 17, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2019

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

Authorized official

Name
Dr. Fred A Tega, M.D.NPI 1043265259
Title
Chief Executive
Phone
(770) 251-5253

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

15 Baynard Park
Newnan, GA 30265

Mailing address

15 Baynard Park
Newnan, GA 30265-6413
Phone (770) 251-5253

Other practice location 1

3229 Highway 34 E
Suite 103
Newnan, GA 30265-2195
Phone (770) 251-5253

Other names 1

  • PRIMECARE PEDIATRICS Doing business as

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
11D1070744Primecare Pediatrics PC15A Baynard Park, Newnan, GA 30265ComplianceOct 26, 2027

National Provider Directory

National Provider Directory

Locations

15 Baynard Park
#A
Newnan, GA 30265

15 Baynard Park
Newnan, GA 30265
Phone (770) 251-5253

Practitioners & affiliated clinicians

Practitioners 4

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": "1213660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549670400000",
    "number": "1396905907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 BAYNARD PARK",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302656413",
            "telephone_number": "770-251-5253",
            "fax_number": "770-251-5254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 BAYNARD PARK",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "30265",
            "telephone_number": "770-251-5253",
            "fax_number": "770-251-5254"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3229 Highway 34 E",
            "address_2": "SUITE 103",
            "address_purpose": "LOCATION",
            "city": "Newnan",
            "state": "GA",
            "postal_code": "302652195",
            "country_code": "US",
            "telephone_number": "770-251-5253",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRIMECARE PEDIATRICS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-17",
        "last_updated": "2019-02-09",
        "status": "A",
        "authorized_official_last_name": "TEGA",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE",
        "authorized_official_telephone_number": "770-251-5253",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRIMECARE PEDIATRICS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PRIMECARE PEDIATRICS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newnan, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2019; 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.