NPIMap

Organization Active NPI

Neonatal Specialist of Georgia

  • Neonatal-Perinatal Medicine Physician
  • Lawrenceville, GA
National Provider Identifier
1578843454
Registry record updated Aug 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
Legal business name
NEONATAL SPECIALIST OF GEORGIA
Practice address
700 Medical Center Blvd
Gwinnett Womens Pavilion
Lawrenceville, GA 30046-7693
Phone
(770) 921-4492
Fax
(770) 696-3358
NPI assigned
Aug 23, 2011
Last updated
Aug 23, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2011

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

Authorized official

Name
Dr. Leslie Dennis Leigh, M.D.NPI 1588727614
Title
President
Phone
(770) 921-4492

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080N0001X Primary

Addresses

Primary practice location

700 Medical Center Blvd
Gwinnett Womens Pavilion
Lawrenceville, GA 30046-7693

Mailing address

PO Box 2606
Lilburn, GA 30048-2606
Phone (770) 921-4492

Other identifiers 22

IdentifierTypeStateIssuer
000700983FMedicaidGA
322060OtherGALEIGH @ WELLCARE
117057MedicaidGA
117063OtherGALEIGH @ PEACHSTATE
803486775GMedicaidGA
000593425GMedicaidGA
083668065KMedicaidGA
000593425CMedicaidGA
000700983BMedicaidGA
000700983DMedicaidGA
10052477OtherGALEIGH @ AMERIGROUP
10052477MedicaidGA
2504776OtherSUSKIN @ AETNA
803486775IMedicaidGA
2504633OtherLEIGH @ AETNA
52051429OtherLEIGH @ BLUE CROSS
803486775FMedicaidGA
322063MedicaidGA
52412187OtherSUSKIN @ BLUE CROSS
000593425DMedicaidGA
083668065JMedicaidGA
083668065MMedicaidGA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1314057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314057600000",
    "number": "1578843454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2606",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300482606",
            "telephone_number": "770-921-4492",
            "fax_number": "770-696-3358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 MEDICAL CENTER BLVD",
            "address_2": "GWINNETT WOMENS PAVILION",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300467693",
            "telephone_number": "770-921-4492",
            "fax_number": "770-696-3358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEONATAL SPECIALIST OF GEORGIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-23",
        "last_updated": "2011-08-23",
        "status": "A",
        "authorized_official_last_name": "LEIGH",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "DENNIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-921-4492",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000700983F",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LEIGH @ WELLCARE",
            "identifier": "322060",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117057",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LEIGH @ PEACHSTATE",
            "identifier": "117063",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "803486775G",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000593425G",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "083668065K",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000593425C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000700983B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000700983D",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LEIGH @ AMERIGROUP",
            "identifier": "10052477",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10052477",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUSKIN @ AETNA",
            "identifier": "2504776",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "803486775I",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LEIGH @ AETNA",
            "identifier": "2504633",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LEIGH @ BLUE CROSS",
            "identifier": "52051429",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "803486775F",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "322063",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUSKIN @ BLUE CROSS",
            "identifier": "52412187",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000593425D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "083668065J",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "083668065M",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2011; 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.