NPIMap

Organization Active NPI

Van Meter Pediatric Endocrinology

  • Pediatric Endocrinology Physician
  • Atlanta, GA
National Provider Identifier
1487967360
Registry record updated Jan 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
034734 Issued in GA
Legal business name
VAN METER PEDIATRIC ENDOCRINOLOGY
Practice address
1800 Howell Mill Rd NW Ste 450
Atlanta, GA 30318-2508
Phone
(678) 961-2100
Fax
(678) 961-2107
NPI assigned
Jul 20, 2010
Organization subpart
Yes
Parent organization
ATLANTA DIABETES ASSOCIATESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 21, 2022

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

Authorized official

Name
Mrs. Bonnie L Bidlack, CREDENTIALING CONT
Title
Credentialing
Phone
(404) 788-5237

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Endocrinology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2080P0205X 034734 GA Primary
Pediatric Endocrinology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2080P0205X 061122 GA

Addresses

Primary practice location

1800 Howell Mill Rd NW Ste 450
Atlanta, GA 30318-2508

Mailing address

1800 Howell Mill Rd NW Ste 450
Atlanta, GA 30318-2508
Phone (404) 355-4393

Other identifiers 1

IdentifierTypeStateIssuer
000468234GMedicaidGA

Other names 1

  • Atlanta Diabetes Associates Doing business as

National Provider Directory

National Provider Directory
Part of
Atlanta Diabetes Associ

Locations

1800 Howell Mill Rd NW
Ste 475
Atlanta, GA 30318
Phone (678) 961-2100

Practitioners & affiliated clinicians

Practitioners 44

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1279584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642723200000",
    "number": "1487967360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 HOWELL MILL RD NW STE 450",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303182508",
            "telephone_number": "404-355-4393",
            "fax_number": "678-961-2107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 HOWELL MILL RD NW STE 450",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303182508",
            "telephone_number": "678-961-2100",
            "fax_number": "678-961-2107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAN METER PEDIATRIC ENDOCRINOLOGY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ATLANTA DIABETES ASSOCIATES",
        "enumeration_date": "2010-07-20",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A",
        "authorized_official_last_name": "BIDLACK",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "404-788-5237",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CREDENTIALING  CONT"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "GA",
            "license": "034734",
            "primary": true
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "GA",
            "license": "061122",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000468234G",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Atlanta Diabetes Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2022; 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.