NPIMap

Organization Active NPI

Peds Care P.C.

  • Pediatrics Physician
  • Dalton, GA
National Provider Identifier
1679730717
Registry record updated Nov 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PEDS CARE P.C.
Practice address
1933 Shields Road
Dalton, GA 30720
Phone
(706) 278-6628
Fax
(706) 278-6650
NPI assigned
May 16, 2008
Last updated
Nov 29, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2010

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

Authorized official

Name
Dr. Ricardo R Riesco, MDNPI 1063435550
Title
Owner
Phone
(706) 278-6628

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X Primary

Addresses

Primary practice location

1933 Shields Road
Dalton, GA 30720

Mailing address

1933 Shields Road
Dalton, GA 30720
Phone (706) 278-6628

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D0262347Peds Care PC1933 Shields Road, Dalton, GA 30720ComplianceDec 15, 2027

National Provider Directory

National Provider Directory

Locations

1933 Shields Rd
Dalton, GA 30720
Phone (706) 278-6628

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1210896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290988800000",
    "number": "1679730717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1933 SHIELDS ROAD",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "30720",
            "telephone_number": "706-278-6628",
            "fax_number": "706-278-6650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1933 SHIELDS ROAD",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "30720",
            "telephone_number": "706-278-6628",
            "fax_number": "706-278-6650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDS CARE P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-16",
        "last_updated": "2010-11-29",
        "status": "A",
        "authorized_official_last_name": "RIESCO",
        "authorized_official_first_name": "RICARDO",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-278-6628",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2010; 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.