Affinity Pediatrics, LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

049525 Issued in GA

Legal business name

AFFINITY PEDIATRICS, LLC

Practice address

2225 US Highway 41 N
Tifton, GA 31794-2749

Phone

(229) 391-4100

NPI assigned

Nov 14, 2009

Last updated

Nov 14, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Becky Wilkerson

Title

Administrator

Phone

(229) 391-4100

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1258156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258156800000",
    "number": "1497082242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2225 US HIGHWAY 41 N",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317942749",
            "telephone_number": "229-391-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 US HIGHWAY 41 N",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317942749",
            "telephone_number": "229-391-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFINITY PEDIATRICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-14",
        "last_updated": "2009-11-14",
        "status": "A",
        "authorized_official_last_name": "WILKERSON",
        "authorized_official_first_name": "BECKY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "229-391-4100"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "049525",
            "primary": true
        },
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "GA",
            "license": "049525",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Advanced Behavioral Health Services of Tifton
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• Affinity Outpatient Services
• Dorothy Dee Agyepong, CPNP
• Air Evac EMS, Inc. (Air Evac Lifeteam)
• Angela Akwugo Akujuobi
• Ibrahim Al Marei, MD
• Omar Al-Rusan, MD

• Pediatrics Physician in Tifton, GA
• Providers in Tifton, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.