Trinity Pediatric Medicine of Fayetteville

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

TRINITY PEDIATRIC MEDICINE OF FAYETTEVILLE

Practice address

3695 Cascade Rd SW Ste V
Atlanta, GA 30331-2146

Phone

(404) 696-6595

NPI assigned

Oct 8, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Paul McKoy

Title

Cfo

Phone

(678) 517-8368

Specialties & licenses 1

Addresses

Locations

Practitioners 4

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

• Shineille Blair, DDS

  • Dentist
  • Fayetteville, GA
  • NPI 1073290185
  NPD (past)
• Phillip Earl Brownlee, DDS

  • General Practice Dentistry
  • Fayetteville, GA
  • NPI 1578363396
  NPD (past)
• Angela M Hall, M.D

  • Pediatrics Physician
  • Atlanta, GA
  • NPI 1770551400
  NPD (past)
• Brittany Wilson, M.D.

  • Pediatrics Physician
  • Atlanta, GA
  • NPI 1043497985
  NPD (past)

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

{
    "created_epoch": "1444262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444262400000",
    "number": "1609247311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 LANIER AVE W STE A2",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3695 CASCADE RD SW STE V",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303312146",
            "telephone_number": "404-696-6595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY PEDIATRIC MEDICINE OF FAYETTEVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-08",
        "last_updated": "2015-10-08",
        "status": "A",
        "authorized_official_last_name": "MCKOY",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "678-517-8368",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Christine Trinidad, PHARM.D
• Trinity Behavioral and Medical Solutions
• Trinity Hospice of Georgia, LLC
• Trinity Medical Solutions, LLC
• Trinity Pediatric Medicine of College Park, LLC
• Trinity Pharmacy Enterprise II LLC
• Trinity Pharmacy Enterprise, LLC
• Marvin Trinkaus II, ATC
• Priti Tripathi
• Jessica Triplett, LCSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2015; 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.