Pediatrix Medical Group

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

License

R030659 Issued in GA

Legal business name

PEDIATRIX MEDICAL GROUP

Practice address

777 Hemlock St
Box 119
Macon, GA 31207-0001

Phone

(478) 633-1626

Fax

(478) 765-4171

NPI assigned

Apr 16, 2007

Organization subpart

No

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

Authorized official

Name

Teresa G Wilder, RNCNNP

Title

Nurse Practitioner

Phone

(478) 765-4132

Specialties & licenses 1

Addresses

Tax ID family

Pediatrix Medical Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Pediatrix Medical Group of Georgia, P.C.

  • Pediatric Critical Care Medicine Physician
  • Marietta, GA
  • NPI 1144172545
  NPD tax ID

Locations

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467677476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 HEMLOCK ST",
            "address_2": "BOX 119",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312070001",
            "telephone_number": "478-633-1626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 HEMLOCK ST",
            "address_2": "BOX 119",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312070001",
            "telephone_number": "478-633-1626",
            "fax_number": "478-765-4171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIX MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILDER",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "478-765-4132",
        "authorized_official_credential": "RNCNNP"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "GA",
            "license": "R030659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pediatric Dentistry of Central Georgia - Macon LLC
• Pediatric Mobility
• Pediatric Mobility
• Pediatric Pulmonology of Central Ga
• Pediatric Services of America, LLC
• Amy Johnson Peed, AU.D.M
• Jacqueline Peed
• Ross T Peery, MS, LPC
• Sarah Peets, M.ED, BCBA
• Heather G Peltier, MD

• General Acute Care Hospital in Macon, GA
• Providers in Macon, GA by specialty
• General Acute Care Hospital in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.