NPIMap

Organization Active NPI

Dawson Pediatrics,PC

  • Pediatrics Physician
  • Dawsonville, GA
National Provider Identifier
1750435749
Registry record updated May 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
48029 Issued in GA
Legal business name
DAWSON PEDIATRICS,PC
Practice address
300 Dawson Commons Cir
Suite 320
Dawsonville, GA 30534-6268
Phone
(706) 216-2771
Fax
(706) 216-2944
NPI assigned
Jan 23, 2007
Last updated
May 8, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2013

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

Authorized official

Name
Dr. Honorio Rowell Bulos, M.D., F.A.A.P.NPI 1497712939
Title
Owner-Physician
Phone
(706) 216-2771

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 PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 48029 GA Primary

Addresses

Primary practice location

300 Dawson Commons Cir
Suite 320
Dawsonville, GA 30534-6268

Mailing address

300 Dawson Commons Cir
Suite 320
Dawsonville, GA 30534-6268
Phone (706) 216-2771

Other identifiers 1

IdentifierTypeStateIssuer
728415762AMedicaidGA

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
11D0909399Dawson Pediatrics PC300 Dawson Commons Circle Suite 320, Dawsonville, GA 30534ComplianceFeb 10, 2027

National Provider Directory

National Provider Directory

Locations

1200 Bald Ridge Marina Rd
Ste 100
Cumming, GA 30041
Phone (706) 216-2771

300 Dawson Commons Cir
Dawsonville, GA 30534
Phone (706) 216-2771

300 Dawson Commons Cir
Ste 320
Dawsonville, GA 30534
Phone (706) 216-2770

Interoperability endpoints

  • Direct secure messaging: carmina.babao@gadirect.net
  • Direct secure messaging: debra.flax@gadirect.net
  • Direct secure messaging: honorio.bulos@gadirect.net
  • Direct secure messaging: joanna.morris@gadirect.net
  • Direct secure messaging: peggy.booher@gadirect.net

Practitioners & affiliated clinicians

Practitioners 20

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 20

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367971200000",
    "number": "1750435749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 DAWSON COMMONS CIR",
            "address_2": "SUITE 320",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "305346268",
            "telephone_number": "706-216-2771",
            "fax_number": "706-216-2944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 DAWSON COMMONS CIR",
            "address_2": "SUITE 320",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "305346268",
            "telephone_number": "706-216-2771",
            "fax_number": "706-216-2944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAWSON PEDIATRICS,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2013-05-08",
        "status": "A",
        "authorized_official_last_name": "BULOS",
        "authorized_official_first_name": "HONORIO",
        "authorized_official_middle_name": "ROWELL",
        "authorized_official_title_or_position": "OWNER-PHYSICIAN",
        "authorized_official_telephone_number": "706-216-2771",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D., F.A.A.P."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "48029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "728415762A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dawsonville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2013; 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.