Coliseum Pediatric and Adolescent Care, Inc

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

23120 Issued in GA

Legal business name

COLISEUM PEDIATRIC AND ADOLESCENT CARE, INC

Practice address

360 Hospital Dr BLDG D
Macon, GA 31217-3874

Phone

(478) 743-4632

Fax

(478) 743-1856

NPI assigned

Dec 19, 2007

Last updated

Dec 19, 2007By 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

Teresa J Trippe, M.D.NPI 1144354010

Title

Owner/Physician

Phone

(478) 743-4632

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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.

• Teresa Joyce Trippe, M.D.

  • Pediatrics Physician
  • Macon, GA
  • NPI 1144354010
  Authorized official Same address or phone

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

{
    "created_epoch": "1198022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198022400000",
    "number": "1437333978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 HOSPITAL DR BLDG D",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312173874",
            "telephone_number": "478-743-4632",
            "fax_number": "478-743-1856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 HOSPITAL DR BLDG D",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312173874",
            "telephone_number": "478-743-4632",
            "fax_number": "478-743-1856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLISEUM PEDIATRIC AND ADOLESCENT CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-19",
        "last_updated": "2007-12-19",
        "status": "A",
        "authorized_official_last_name": "TRIPPE",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "478-743-4632",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "23120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85002369G",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Coliseum Health Group, LLC (Coliseum Primary Healthcare)
• Coliseum Medical Center, LLC (Piedmont Macon Medical Center)
• Coliseum Medical Center, LLC (Piedmont Macon Medical Center)
• Coliseum Medical Center, LLC (Piedmont Macon Medical Center)
• Coliseum Park Cancer Treatment Center
• Coliseum Primary Care Services, LLC (Coliseum Medical Group-Northside)
• Coliseum Same Day Surgery Center LP
• April Nicole Colley, CPNP
• Collier B. Gladin, Jr., M.D., LLC (Collier B Gladin Jr MD)
• Deborah Lusendia Collier, FNP-C

• Pediatrics Physician in Macon, GA
• Providers in Macon, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 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.