NPIMap

Organization Active NPI

Healthy Steps Pediatrics, LLC

  • Primary Care Clinic/Center
  • Marietta, GA
National Provider Identifier
1548567019
Registry record updated Dec 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
RN138345NP Issued in GA
Legal business name
HEALTHY STEPS PEDIATRICS, LLC
Practice address
3911 Mary Eliza Trce NW
Suite 200
Marietta, GA 30064-1086
Phone
(678) 384-3480
Fax
(678) 384-3481
NPI assigned
Feb 18, 2011
Last updated
Dec 19, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2011

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

Authorized official

Name
Mary Barnes Hammock, CPNP
Title
Owner
Phone
(678) 384-3480

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X RN138345NP GA Primary

Addresses

Primary practice location

3911 Mary Eliza Trce NW
Suite 200
Marietta, GA 30064-1086

Mailing address

3911 Mary Eliza Trce NW
Suite 200
Marietta, GA 30064-1086
Phone (678) 384-3480

Other identifiers 1

IdentifierTypeStateIssuer
000978436DMedicaidGA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2019202Healthy Steps Pediatrics, LLC3911 Mary Eliza Trace, Suite 200, Marietta, GA 30064Certificate of waiverJan 24, 2027

National Provider Directory

National Provider Directory

Locations

3911 Mary Eliza Trce NW
Ste 500
Marietta, GA 30064
Phone (678) 384-3480

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1297987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324252800000",
    "number": "1548567019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3911 MARY ELIZA TRCE NW",
            "address_2": "SUITE 200",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300641086",
            "telephone_number": "678-384-3480",
            "fax_number": "678-384-3481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3911 MARY ELIZA TRCE NW",
            "address_2": "SUITE 200",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300641086",
            "telephone_number": "678-384-3480",
            "fax_number": "678-384-3481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY STEPS PEDIATRICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-18",
        "last_updated": "2011-12-19",
        "status": "A",
        "authorized_official_last_name": "HAMMOCK",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "BARNES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-384-3480",
        "authorized_official_credential": "CPNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "GA",
            "license": "RN138345NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000978436D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.