Organization Active NPI

Milledgeville Pediatrics PC

  • Pediatrics Physician
  • Milledgeville, GA
National Provider Identifier
1558500983
Registry record updated Aug 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
MILLEDGEVILLE PEDIATRICS PC
Practice address
750 N Cobb St Ste 230
Milledgeville, GA 31061-7162
Phone
(478) 453-9383
Fax
(478) 452-1147
NPI assigned
Feb 9, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2011

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

Authorized official

Name
Mrs. Lakeycia Michelle Robinson
Title
Office Manager
Phone
(478) 453-9383

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

750 N Cobb St Ste 230
Milledgeville, GA 31061-7162

Mailing address

750 N Cobb St Ste 230
Milledgeville, GA 31061-7162
Phone (478) 453-9383

Other identifiers 2

IdentifierTypeStateIssuer
00011822AMedicaidGA
741629148AMedicaidGA

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
11D0263671Milledgeville Pediatrics, PC750 North Cobb Street, Suite 230, Milledgeville, GA 31061Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

750 N Cobb St
Ste 230
Milledgeville, GA 31061
Phone (478) 453-9383

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1234137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312761600000",
    "number": "1558500983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 N COBB ST STE 230",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310617162",
            "telephone_number": "478-453-9383",
            "fax_number": "478-452-1147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 N COBB ST STE 230",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310617162",
            "telephone_number": "478-453-9383",
            "fax_number": "478-452-1147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLEDGEVILLE PEDIATRICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-09",
        "last_updated": "2011-08-08",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "LAKEYCIA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "478-453-9383",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00011822A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "741629148A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milledgeville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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.