NPIMap

Organization Active NPI

Kids Health

  • Pediatrics Physician
  • Fitzgerald, GA
National Provider Identifier
1629302260
Registry record updated Sep 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
026873 Issued in GA
Legal business name
KIDS HEALTH
Practice address
119 Norman Dorminy Dr Ste a
Fitzgerald, GA 31750-8855
Phone
(229) 423-5437
Fax
(229) 424-0868
NPI assigned
Sep 30, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2009

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

Authorized official

Name
Mrs. Lara Mills
Title
Office Manager
Phone
(229) 424-7341

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 026873 GA Primary

Addresses

Primary practice location

119 Norman Dorminy Dr Ste a
Fitzgerald, GA 31750-8855

Mailing address

PO Box 1027
Fitzgerald, GA 31750-1027
Phone (229) 423-5437

National Provider Directory

National Provider Directory
Tax ID family
Dorminy Memorial Hosp4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1254268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254268800000",
    "number": "1629302260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1027",
            "city": "FITZGERALD",
            "state": "GA",
            "postal_code": "317501027",
            "telephone_number": "229-423-5437",
            "fax_number": "229-424-0868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 NORMAN DORMINY DR STE A",
            "city": "FITZGERALD",
            "state": "GA",
            "postal_code": "317508855",
            "telephone_number": "229-423-5437",
            "fax_number": "229-424-0868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-30",
        "last_updated": "2009-09-30",
        "status": "A",
        "authorized_official_last_name": "MILLS",
        "authorized_official_first_name": "LARA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "229-424-7341",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "026873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fitzgerald, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2009; 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.