Pedsmd LLC

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

PEDSMD LLC

Practice address

4941 S Old Peachtree Rd Ste B
Peachtree Corners, GA 30092-3495

Phone

(678) 960-8316

Fax

(678) 550-6569

NPI assigned

Jun 1, 2023

Last updated

Jun 1, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Fabian Chang, MDNPI 1659722494

Title

MD/Ceo

Phone

(678) 960-8316

Specialties & licenses 2

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Fabian L Chang, MD

  • Pediatrics Physician
  • Watkinsville, GA
  • NPI 1659722494
  NPD Authorized official
• Lily Lee, MD

  • Pediatrics Physician
  • Peachtree Corners, GA
  • NPI 1083363246
  NPD

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

{
    "created_epoch": "1685577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685577600000",
    "number": "1659064921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4941 S OLD PEACHTREE RD STE B",
            "city": "PEACHTREE CORNERS",
            "state": "GA",
            "postal_code": "300923495",
            "telephone_number": "678-960-8316",
            "fax_number": "678-550-6569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4941 S OLD PEACHTREE RD STE B",
            "city": "PEACHTREE CORNERS",
            "state": "GA",
            "postal_code": "300923495",
            "telephone_number": "678-960-8316",
            "fax_number": "678-550-6569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDSMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-01",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "FABIAN",
        "authorized_official_title_or_position": "MD/CEO",
        "authorized_official_telephone_number": "678-960-8316",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Urgent Care Clinic/Center in Peachtree Corners, GA
• Providers in Peachtree Corners, GA by specialty
• Urgent Care Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; 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.