Individual provider Active NPI

Noreen Islam, MD

  • Pediatric Endocrinology Physician
  • Atlanta, GA
National Provider Identifier
1710349923
Registry record updated Jul 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
83400 Issued in GA
Practice address
5445 Meridian Mark Rd Ste 420
Atlanta, GA 30342-4755
Phone
(404) 785-5437
Fax
(404) 785-9022
NPI assigned
Mar 26, 2016
Last updated
Jul 12, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Endocrinology Physician 2080P0205X 83400 GA Primary

Addresses

Primary practice location

5445 Meridian Mark Rd Ste 420
Atlanta, GA 30342-4755

Mailing address

5445 Meridian Mark Rd Ste 420
Atlanta, GA 30342-4755
Phone (404) 785-5437

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180619002545 CA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 8123373917

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
83400GAMDPediatric Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scottish Rite Children's Medical Center Past Accepting new patients
Choa Multispecialty, LLC Pediatric Endocrinology Past Accepting new patients
Scottish Rite Childrens Medical Ctr Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1458950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1710349923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5445 MERIDIAN MARK RD STE 420",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303424755",
            "telephone_number": "404-785-5437",
            "fax_number": "404-785-9022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5445 MERIDIAN MARK RD STE 420",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303424755",
            "telephone_number": "404-785-5437",
            "fax_number": "404-785-9022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISLAM",
        "first_name": "NOREEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-26",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "GA",
            "license": "83400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.