Karem Vivian Menezes, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

81618 Issued in GA

Practice address

204 Canton Rd
Cumming, GA 30040-2304

Phone

(770) 886-5437

Fax

(770) 886-9717

NPI assigned

Mar 19, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Lakeside Pediatrics, LLC

  • Pediatrics Physician
  • Cumming, GA
  • NPI 1326317520
  NPD (past)

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

{
    "created_epoch": "1332115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566777600000",
    "number": "1548535800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2155",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411052155",
            "telephone_number": "606-474-0669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 CANTON RD",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300402304",
            "telephone_number": "770-886-5437",
            "fax_number": "770-886-9717"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Bellefonte Dr",
            "address_purpose": "LOCATION",
            "city": "Grayson",
            "state": "KY",
            "postal_code": "411431820",
            "country_code": "US",
            "telephone_number": "606-474-0669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENEZES",
        "first_name": "KAREM",
        "middle_name": "VIVIAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-19",
        "last_updated": "2019-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "45369",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "TRN 13410",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "81618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100211610",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "81618",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eve Lutrell Melendez, PAC
• Melissa J. McGinnis M.D.
• Melody in Motion Communication & Developmental Services LLC
• Alexis Jovann Mendez, MA, BCBA
• Alejandro Andres Mendoza
• Rachel Menzoian
• Kori Alyssa Mepham, PT, DPT
• Jeremy Chad Merritt, LPC
• Olivia Grace Merritt, OTR/L
• Stephanie C Merritt, DPM

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2019; 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.