Epps Bridge Pediatrics, LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

47265 Issued in GA

Legal business name

EPPS BRIDGE PEDIATRICS, LLC

Practice address

1061 Dowdy Rd
202
Athens, GA 30606-5700

Phone

(706) 621-7575

Fax

(706) 621-7557

NPI assigned

Jun 25, 2015

Last updated

Jun 25, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Arundhathi K Reddy

Title

Cfo

Phone

(706) 621-7575

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1435190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435190400000",
    "number": "1407238405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "POST OFFICE BOX 529",
            "city": "ROYSTON",
            "state": "GA",
            "postal_code": "306620529",
            "telephone_number": "706-621-7575",
            "fax_number": "706-621-7557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 DOWDY RD",
            "address_2": "202",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306065700",
            "telephone_number": "706-621-7575",
            "fax_number": "706-621-7557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EPPS BRIDGE PEDIATRICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-25",
        "last_updated": "2015-06-25",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "ARUNDHATHI",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "706-621-7575",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "47265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Athens, GA
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2015; 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.