Individual provider Active NPI

Michael Phillip Fundora, M.D.

  • Pediatric Cardiology Physician
  • Atlanta, GA
National Provider Identifier
1770846149
Registry record updated Apr 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
82395 Issued in GA
Practice address
2220 N Druid Hills Rd NE
Atlanta, GA 30329-3117
Phone
(404) 256-2593
Fax
(770) 488-9408
NPI assigned
Jun 20, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 82395 GA Primary
Pediatric Critical Care Medicine Physician 2080P0203X 269973 MA
Student in an Organized Health Care Education/Training Program 390200000X TRN16214 FL

Addresses

Primary practice location

2220 N Druid Hills Rd NE
Atlanta, GA 30329-3117

Mailing address

2970 Brandywine Rd Ste 125
Atlanta, GA 30341-5521
Phone (404) 256-2593

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sibley@choa.gadirect.com Health Information Exchange (HIE) Children's Healthcare of Atlanta

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20190607002315 GA Practitioner - Pediatric Medicine 6305179219 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
269973MAMDRegistered Nurse
82395GAMDPediatric Cardiology Physician
TRN16214FLMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Healthcare of Atlanta Cardiology Inc Pediatric Cardiology CurrentSince Apr 30, 2019 Accepting new patients

Locations

2970 Brandywine Rd
Ste 125
Atlanta, GA 30341
Phone (713) 790-9401

1405 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 785-1112

60 Executive Park South NE
Atlanta, GA 30329

2835 Brandywine Rd
Ste 400
Atlanta, GA 30341

2220 N Druid Hills Rd NE
Brookhaven, GA 30329
Phone (404) 778-1440

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1340150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776988800000",
    "number": "1770846149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2970 BRANDYWINE RD STE 125",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303415521",
            "telephone_number": "404-256-2593",
            "fax_number": "770-488-9408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2220 N DRUID HILLS RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303293117",
            "telephone_number": "404-256-2593",
            "fax_number": "770-488-9408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNDORA",
        "first_name": "MICHAEL",
        "middle_name": "PHILLIP",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-20",
        "last_updated": "2026-04-24",
        "certification_date": "2026-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "GA",
            "license": "82395",
            "primary": true
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "MA",
            "license": "269973",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "TRN16214",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sibley@choa.gadirect.com",
            "affiliation": "Y",
            "endpointDescription": "Sibley",
            "affiliationName": "Children's Healthcare of Atlanta",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "PHI",
            "address_1": "1405 Clifton Rd NE",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "30322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.