NPIMap

Organization Active NPI

Milestone Pediatrics and Family Medicine

  • Pediatrics Physician
  • Decatur, GA
National Provider Identifier
1699918052
Registry record updated Jun 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
051008 Issued in GA
Legal business name
MILESTONE PEDIATRICS AND FAMILY MEDICINE
Practice address
1438 McLendon Dr
Decatur, GA 30033-1802
Phone
(770) 414-0337
Fax
(770) 414-0354
NPI assigned
Apr 15, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2013

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

Authorized official

Name
Dr. Iyabo Y Okuwobi, MD
Title
Pediatrician
Phone
(770) 414-0337

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 051008 GA Primary

Addresses

Primary practice location

1438 McLendon Dr
Decatur, GA 30033-1802

Mailing address

1438 McLendon Dr
Decatur, GA 30033-1802
Phone (770) 414-0337

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1239753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371427200000",
    "number": "1699918052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1438 MCLENDON DR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300331802",
            "telephone_number": "770-414-0337",
            "fax_number": "770-414-0354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1438 MCLENDON DR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300331802",
            "telephone_number": "770-414-0337",
            "fax_number": "770-414-0354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILESTONE PEDIATRICS AND FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-15",
        "last_updated": "2013-06-17",
        "status": "A",
        "authorized_official_last_name": "OKUWOBI",
        "authorized_official_first_name": "IYABO",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "PEDIATRICIAN",
        "authorized_official_telephone_number": "770-414-0337",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "051008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2013; 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.