Active NPI
Joe C Liu, M.D.
- Pediatrics Physician
- Doraville, GA
National Provider Identifier
1659369593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 017403
- Practice address
- 5150 Buford Hwy
Ste C-200
Doraville, GA 30340-1153 - Phone
- (770) 454-9199
- Fax
- (770) 458-1388
- NPI assigned
- Oct 13, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ph.D. Medical Genetics | 170100000X | 17403 | GA | |
| Pediatrics Physician | 208000000X | 017403 | GA | Primary |
Addresses
Primary practice location
5150 Buford Hwy
Ste C-200
Doraville, GA 30340-1153
Mailing address
5150 Buford Hwy
Ste C-200
Doraville, GA 30340-1153
Phone (770) 454-9199
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00069275A | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17403 | GA | MD | Ph.D. Medical Genetics |
| 017403 | GA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Medical Center PC | Pediatrics | Past | Accepting new patients |
| Southern OB GYN Associates P C | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Obstetrics & Gynecology Physician
- Valdosta, GA
- NPI 1801951454
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1261008000000",
"number": "1659369593",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5150 BUFORD HWY",
"address_2": "STE C-200",
"city": "DORAVILLE",
"state": "GA",
"postal_code": "303401153",
"telephone_number": "770-454-9199",
"fax_number": "770-458-1388"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5150 BUFORD HWY",
"address_2": "STE C-200",
"city": "DORAVILLE",
"state": "GA",
"postal_code": "303401153",
"telephone_number": "770-454-9199",
"fax_number": "770-458-1388"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIU",
"first_name": "JOE",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-13",
"last_updated": "2009-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "170100000X",
"taxonomy_group": "",
"desc": "Medical Genetics, Ph.D. Medical Genetics",
"state": "GA",
"license": "17403",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "GA",
"license": "017403",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00069275A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Doraville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 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.