NPIMap

Organization Active NPI

Potts and Smith Pediatrics

  • Pediatrics Physician
  • Fayetteville, GA
National Provider Identifier
1457510158
Registry record updated Jun 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
017642 Issued in GA
Legal business name
POTTS AND SMITH PEDIATRICS
Practice address
365 N Jeff Davis Dr
Fayetteville, GA 30214-1627
Phone
(770) 461-5003
Fax
(770) 461-4939
NPI assigned
Jun 6, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2008

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

Authorized official

Name
Mrs. Deborah J Staats
Title
Office Administrator
Phone
(770) 461-5003

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208000000X 017642 GA Primary

Addresses

Primary practice location

365 N Jeff Davis Dr
Fayetteville, GA 30214-1627

Mailing address

365 N Jeff Davis Dr
Fayetteville, GA 30214-1627
Phone (770) 461-5003

National Provider Directory

National Provider Directory

Locations

365 N Jeff Davis Dr
Fayetteville, GA 30214
Phone (770) 461-5003

Practitioners & affiliated clinicians

Practitioners 6

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": "1212710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212710400000",
    "number": "1457510158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 N JEFF DAVIS DR",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141627",
            "telephone_number": "770-461-5003",
            "fax_number": "770-461-4939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 N JEFF DAVIS DR",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141627",
            "telephone_number": "770-461-5003",
            "fax_number": "770-461-4939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTTS AND SMITH PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-06",
        "last_updated": "2008-06-06",
        "status": "A",
        "authorized_official_last_name": "STAATS",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "770-461-5003",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "017642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2008; 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.