Children's Medicine of Rockdale

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

CHILDREN'S MEDICINE OF ROCKDALE

Practice address

1765 Parker Rd SE
Suite B210
Conyers, GA 30094-6652

Phone

(770) 761-0672

NPI assigned

Jun 16, 2009

Last updated

May 10, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Dan Eysie

Title

Owner

Phone

(404) 448-4652

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1245110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336608000000",
    "number": "1770710824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1765 PARKER RD",
            "address_2": "SUITE B210",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "30094",
            "telephone_number": "770-761-0672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1765 PARKER RD SE",
            "address_2": "SUITE B210",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300946652",
            "telephone_number": "770-761-0672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S MEDICINE OF ROCKDALE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-16",
        "last_updated": "2012-05-10",
        "status": "A",
        "authorized_official_last_name": "EYSIE",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-448-4652",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth Chen, M.D.
• Dartiss May Chevalier, PMHNP-BC
• Kenyatta Chichester, RDH
• Chinyere Chigbu, FNP-C
• Children's Medical Central
• Inyoung Choi, DMD
• Choice Nursing Services,LLC
• Christ-Lee Hospice and Palliative Care
• Shannon Christian
• Ellica Moore Chu

• Pediatrics Physician in Conyers, GA
• Providers in Conyers, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2012; 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.