Individual provider Active NPI

Betsy Cherian John, MD

  • Pediatrics Physician
  • Tucker, GA
National Provider Identifier
1467558189
Registry record updated Jun 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
055377 Issued in GA
Practice address
2007 Montreal Rd
Tucker, GA 30084
Phone
(770) 491-1285
Fax
(770) 491-3164
NPI assigned
Sep 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 055377 GA Primary

Addresses

Primary practice location

2007 Montreal Rd
Tucker, GA 30084

Mailing address

2007 Montreal Rd
Tucker, GA 30084
Phone (770) 491-1285

Other identifiers 1

IdentifierTypeStateIssuer
889893685AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
055377GAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Wellness Center Pediatrics Past Accepting new patients
Verras Pediatrics PC Pediatrics Past Accepting new patients
Northside Pediatrics & Adolescent Medicine PC Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: bjohn10872@choa.gadirect.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246233600000",
    "number": "1467558189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2007 MONTREAL RD",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "30084",
            "telephone_number": "770-491-1285",
            "fax_number": "770-491-3164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2007 MONTREAL RD",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "30084",
            "telephone_number": "770-491-1285",
            "fax_number": "770-491-3164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHN",
        "first_name": "BETSY",
        "middle_name": "CHERIAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2009-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "055377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "889893685A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucker, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2009; 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.