NPIMap

Organization Active NPI

Edward M. Gotlieb, M.D., Et Al Dba the Pediatric Center

Doing business as The Pediatric Center

  • Pediatrics Physician
  • Stone Mountain, GA
National Provider Identifier
1619197498
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
EDWARD M. GOTLIEB, M.D., ET AL DBA THE PEDIATRIC CENTER
Doing business as
The Pediatric Center
Practice address
5405 Memorial Dr
Building D
Stone Mountain, GA 30083-3234
Phone
(404) 296-3800
Fax
(404) 297-8753
NPI assigned
Apr 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ally Dobbs, A.B.A.
Title
Practice Administrator
Phone
(404) 296-3800

Specialties & licenses 1

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

Addresses

Primary practice location

5405 Memorial Dr
Building D
Stone Mountain, GA 30083-3234

Mailing address

5405 Memorial Dr
Building D
Stone Mountain, GA 30083-3234
Phone (404) 296-3800

Other names 1

  • The Pediatric Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Edward M Gotlieb MD Et Al Dba the Pediatric Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5405 Memorial Dr
Ste D
Stone Mountain, GA 30083
Phone (404) 296-3800

Interoperability endpoints

  • Direct secure messaging: laura.yedvobnick@gadirect.net
  • Direct secure messaging: jaquelin.gotlieb@gadirect.net
  • Direct secure messaging: lucinda.sellers@gadirect.net
  • Direct secure messaging: margaret.duly@tpc.gadirect.net
  • Direct secure messaging: trinity.hochstetler@tpc.gadirect.net
  • Direct secure messaging: edward.gotlieb@tpc.gadirect.net
  • Direct secure messaging: lucinda.sellers@tpc.gadirect.net
  • Direct secure messaging: mary.kathleen@tpc.gadirect.net
  • Direct secure messaging: laura.yedvobnick@tpc.gadirect.net
  • Direct secure messaging: edward.gotlieb@gadirect.net

Practitioners & affiliated clinicians

Practitioners 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619197498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5405 MEMORIAL DR",
            "address_2": "BUILDING D",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300833234",
            "telephone_number": "404-296-3800",
            "fax_number": "404-297-8753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5405 MEMORIAL DR",
            "address_2": "BUILDING D",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300833234",
            "telephone_number": "404-296-3800",
            "fax_number": "404-297-8753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD M. GOTLIEB, M.D., ET AL DBA THE PEDIATRIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DOBBS",
        "authorized_official_first_name": "ALLY",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "404-296-3800",
        "authorized_official_credential": "A.B.A."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Pediatric Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stone Mountain, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.