Active NPI
Grayson Pediatrics Mobile
- Pediatrics Physician
- Loganville, GA
National Provider Identifier
1649880667
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- Legal business name
- GRAYSON PEDIATRICS MOBILE
- Practice address
- 297 Cooper Rd Ste B
Loganville, GA 30052-2518 - Phone
- (888) 778-2429
- Fax
- (470) 410-8905
- NPI assigned
- Aug 4, 2020
- Organization subpart
- Yes
- Parent organization
- GRAYSON PEDIATRICS, LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Julie A Opeka, CPNP
- Title
- Co-Founder, Co-Owner, CPNP
- Phone
- (888) 778-2429
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | Primary |
Addresses
Primary practice location
297 Cooper Rd Ste B
Loganville, GA 30052-2518
Mailing address
297 Cooper Rd Ste B
Loganville, GA 30052-2518
Phone (888) 778-2429
National Provider Directory
National Provider Directory- Part of
- Grayson Pediatrics LLC
Locations
297 Cooper Rd
Ste B
Loganville, GA 30052
Phone (888) 778-2429
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1596499200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1596499200000",
"number": "1649880667",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "297 COOPER RD STE B",
"city": "LOGANVILLE",
"state": "GA",
"postal_code": "300522518",
"telephone_number": "888-778-2429",
"fax_number": "470-410-8905"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "297 COOPER RD STE B",
"city": "LOGANVILLE",
"state": "GA",
"postal_code": "300522518",
"telephone_number": "888-778-2429",
"fax_number": "470-410-8905"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GRAYSON PEDIATRICS MOBILE",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "GRAYSON PEDIATRICS, LLC",
"enumeration_date": "2020-08-04",
"last_updated": "2020-08-04",
"certification_date": "2020-08-04",
"status": "A",
"authorized_official_last_name": "OPEKA",
"authorized_official_first_name": "JULIE",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "CO-FOUNDER, CO-OWNER, CPNP",
"authorized_official_telephone_number": "888-778-2429",
"authorized_official_credential": "CPNP"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pediatrics",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Loganville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.