Genesys Pediatrics LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

051567 Issued in GA

Legal business name

GENESYS PEDIATRICS LLC

Practice address

3598 Panola Rd
Lithonia, GA 30038-2731

Phone

(770) 987-2323

Fax

(770) 987-4145

NPI assigned

Jun 17, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Douglas Liggion

Title

Office Manager

Phone

(770) 987-2323

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1213660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1477713006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3598 PANOLA RD",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300382731",
            "telephone_number": "770-987-2323",
            "fax_number": "770-987-4145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3598 PANOLA RD",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300382731",
            "telephone_number": "770-987-2323",
            "fax_number": "770-987-4145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESYS PEDIATRICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-17",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "LIGGION",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "770-987-2323",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "051567",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000960913D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Lithonia, GA
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.