Meadow Pediatrics, PLLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

63377 Issued in GA

Legal business name

MEADOW PEDIATRICS, PLLC

Practice address

10710 Medlock Bridge Rd Ste 250
Johns Creek, GA 30097-1827

Phone

(310) 707-8359

Fax

(770) 825-9001

NPI assigned

Aug 14, 2012

Organization subpart

No

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

Authorized official

Name

Sridevi Muthukumar, MD

Title

Owner

Phone

(310) 707-8359

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1344902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344902400000",
    "number": "1669729257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10710 MEDLOCK BRIDGE RD STE 250",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300971827",
            "telephone_number": "310-707-8359",
            "fax_number": "770-825-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10710 MEDLOCK BRIDGE RD STE 250",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300971827",
            "telephone_number": "310-707-8359",
            "fax_number": "770-825-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEADOW PEDIATRICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-14",
        "last_updated": "2012-08-14",
        "status": "A",
        "authorized_official_last_name": "MUTHUKUMAR",
        "authorized_official_first_name": "SRIDEVI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-707-8359",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "63377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "558938842B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madeline McGarrah
• Thomas McGinn, DO
• Nancy Leigh McIntyre, D.O.
• Tamara Chanelle McNeil, LPC
• Danah Carla McPherson, FNP-BC
• Meadows Hand and Physical Therapy Clinic
• Erin Elizabeth Meason, NCC, APC
• Medlock Pharmacy LLC
• Medlock Surgical Center LLC
• Erik Brandon Meeker, PT, DPT

• Pediatrics Physician in Johns Creek, GA
• Providers in Johns Creek, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.