Pediatric Associates, PC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

025457 Issued in GA

Legal business name

PEDIATRIC ASSOCIATES, PC

Practice address

3000 Johnson Ferry Rd
Suite 204
Marietta, GA 30062-5683

Phone

(770) 993-2922

Fax

(770) 993-7325

NPI assigned

May 21, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Robert M. Licata, MDNPI 1326006552

Title

President

Phone

(770) 993-2922

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert Michael Licata, MD

  • Pediatrics Physician
  • Marietta, GA
  • NPI 1326006552
  NPD (past) Authorized official
• Marygrace Reyes Ani, MD

  • Pediatrics Physician
  • Marietta, GA
  • NPI 1811955826
  NPD (past)
• Gail Beulah Pikholz, MD

  • Pediatrics Physician
  • Marietta, GA
  • NPI 1306804307
  NPD (past)

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790994317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 JOHNSON FERRY RD",
            "address_2": "SUITE 204",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300625683",
            "telephone_number": "770-993-2922",
            "fax_number": "770-993-7325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 JOHNSON FERRY RD",
            "address_2": "SUITE 204",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300625683",
            "telephone_number": "770-993-2922",
            "fax_number": "770-993-7325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LICATA",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-993-2922",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "025457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alica Ann Peavey, FNP
• Arnanla Peay, RBT
• Stephanie Eve Peccia, PHARMD
• Mary Pate Pecunia, MS, EDS, LPC
• Pediatric and Adolescent Healthcare,PC
• Pediatric Smile Studio
• Pediatrics and Adolescent Medicine, PA
• Pediatrics at Whitlock P.C.
• Pediatrix Medical Group of Georgia, P.C.
• Tatiana Peduri

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.