John Richard Paddock, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

911 Issued in GA

Practice address

1708 Peachtree St NW
Suite 400
Atlanta, GA 30309-2434

Phone

(404) 874-3498

Fax

(404) 874-8305

NPI assigned

Feb 18, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1297987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298246400000",
    "number": "1720385289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708 PEACHTREE ST NW",
            "address_2": "SUITE 400",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303097022",
            "telephone_number": "404-874-3498",
            "fax_number": "404-874-8305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 PEACHTREE ST NW",
            "address_2": "SUITE 400",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303092434",
            "telephone_number": "404-874-3498",
            "fax_number": "404-874-8305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADDOCK",
        "first_name": "JOHN",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-02-18",
        "last_updated": "2011-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NM",
            "license": "1085",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jillian Marie Packer, PHARMD, BCPPS
• Julia Michelle Packer, LMSW, MPH
• Pad Specialists - Atlanta LLC
• Taylor Nicole Padawer, MS, LAMFT
• Christopher Paddock, M.D.
• Margaret B Paddock, PT
• Matthew Paden, MD
• Lynne S Padgett, PHD
• Kristin Marie Dobies Padilla, DPT
• Raymond Eralino Padilla, PT, DPT

• Psychologist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2011; 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.