NPIMap

Organization Active NPI

Pediatric First, PC

  • Pediatrics Physician
  • Warner Robins, GA
National Provider Identifier
1407894165
Registry record updated Apr 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
015890 Issued in GA
Legal business name
PEDIATRIC FIRST, PC
Practice address
1049 N Houston Rd
Warner Robins, GA 31093-1505
Phone
(478) 922-9001
Fax
(478) 329-8619
NPI assigned
Jun 3, 2006
Last updated
Apr 13, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2009

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

Authorized official

Name
Santanu Das, MDNPI 1679530638
Title
Physician-Owner
Phone
(478) 922-9001

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 015890 GA Primary
Neonatal-Perinatal Medicine Physician 2080N0001X 052204 GA
Neonatal-Perinatal Medicine Physician 2080N0001X 042560 GA
Pediatric Cardiology Physician 2080P0202X 015890 GA

Addresses

Primary practice location

1049 N Houston Rd
Warner Robins, GA 31093-1505

Mailing address

1049 N Houston Rd
Warner Robins, GA 31093-1505
Phone (478) 922-9001

Other identifiers 1

IdentifierTypeStateIssuer
011397770AMedicaidGA

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
11D0726627Pediatric First, PC1049 N Houston Rd, Warner Robins, GA 31093Certificate of waiverJun 23, 2027

National Provider Directory

National Provider Directory

Locations

1049 N Houston Rd
Warner Robins, GA 31093
Phone (478) 231-5977

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239580800000",
    "number": "1407894165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1049 N HOUSTON RD",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310931505",
            "telephone_number": "478-922-9001",
            "fax_number": "478-329-8619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1049 N HOUSTON RD",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310931505",
            "telephone_number": "478-922-9001",
            "fax_number": "478-329-8619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC FIRST, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2009-04-13",
        "status": "A",
        "authorized_official_last_name": "DAS",
        "authorized_official_first_name": "SANTANU",
        "authorized_official_title_or_position": "PHYSICIAN-OWNER",
        "authorized_official_telephone_number": "478-922-9001",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "015890",
            "primary": true
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "GA",
            "license": "052204",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "GA",
            "license": "042560",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "GA",
            "license": "015890",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "011397770A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warner Robins, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2009; 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.