Organization Active NPI

Children 1St Pediatrics

  • Pediatrics Physician
  • Fayetteville, GA
National Provider Identifier
1629269865
Registry record updated Jan 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
CHILDREN 1ST PEDIATRICS
Practice address
101 Beckett LN
Suite 502
Fayetteville, GA 30214-7155
Phone
(678) 817-1000
Fax
(678) 817-1001
NPI assigned
Aug 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2008

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

Authorized official

Name
Mrs. Valarie Wright Manley, M.D.
Title
Physician
Phone
(678) 817-1000

Specialties & licenses 1

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

Addresses

Primary practice location

101 Beckett LN
Suite 502
Fayetteville, GA 30214-7155

Mailing address

101 Beckett LN
Suite 502
Fayetteville, GA 30214-7155
Phone (678) 817-1000

Other identifiers 1

IdentifierTypeStateIssuer
00436994DMedicaidGA

National Provider Directory

National Provider Directory
Tax ID family
Children 1St Pediatrics2 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.

NPI Registry JSON

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199750400000",
    "number": "1629269865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BECKETT LN",
            "address_2": "SUITE 502",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147155",
            "telephone_number": "678-817-1000",
            "fax_number": "678-817-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BECKETT LN",
            "address_2": "SUITE 502",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147155",
            "telephone_number": "678-817-1000",
            "fax_number": "678-817-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN 1ST PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-05",
        "last_updated": "2008-01-08",
        "status": "A",
        "authorized_official_last_name": "MANLEY",
        "authorized_official_first_name": "VALARIE",
        "authorized_official_middle_name": "WRIGHT",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "678-817-1000",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.D."
    },
    "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": "00436994D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2008; 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.