Individual provider Active NPI

Patricio A Frias

  • Pediatric Cardiology Physician
  • Snellville, GA
National Provider Identifier
1790735520
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
048629 Issued in GA
Practice address
1700 Tree LN
Ste 330
Snellville, GA 30078-6782
Phone
(404) 256-2593
Fax
(678) 547-1494
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 048629 GA Primary

Addresses

Primary practice location

1700 Tree LN
Ste 330
Snellville, GA 30078-6782

Mailing address

2835 Brandywine Rd
#300
Atlanta, GA 30341-5540
Phone (770) 488-9202

Other identifiers 1

IdentifierTypeStateIssuer
00873287AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Healthcare of Atlanta Cardiology Inc Pediatric Cardiology Past Accepting new patients

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790735520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2835 BRANDYWINE RD",
            "address_2": "#300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303415540",
            "telephone_number": "770-488-9202",
            "fax_number": "678-471-1499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 TREE LN",
            "address_2": "STE 330",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300786782",
            "telephone_number": "404-256-2593",
            "fax_number": "678-547-1494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIAS",
        "first_name": "PATRICIO",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "GA",
            "license": "048629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00873287A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.