Egleston Pediatric Group

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

EGLESTON PEDIATRIC GROUP

Practice address

1405 Clifton Rd NE
Atlanta, GA 30322-1060

Phone

(404) 785-6000

NPI assigned

Jan 22, 2007

Organization subpart

No

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

Authorized official

Name

Louetta Cody

Title

Manager, Provider Enrollment

Phone

(404) 785-7876

Specialties & licenses 8

Addresses

Locations

Practitioners 216

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

• Ahmed Assim Aljudi, MD

  • Hematology (Pathology) Physician
  • Atlanta, GA
  • NPI 1912246307
  NPD
• John Addison Alsobrook, MD

  • Sports Medicine (Family Medicine) Physician
  • Buford, GA
  • NPI 1245291616
  NPD
• Omayma Amin

  • Pediatric Infectious Diseases Physician
  • Atlanta, GA
  • NPI 1629462007

  Pediatrics

  NPD
• Evan J Anderson, M.D.

  • Pediatric Infectious Diseases Physician
  • Atlanta, GA
  • NPI 1427250661
  NPD
• Vipin Bansal, MD

  • Anesthesiology Physician
  • Atlanta, GA
  • NPI 1962676312
  NPD
• Frank Berkowitz, MD

  • Pediatric Hematology & Oncology Physician
  • Atlanta, GA
  • NPI 1235171562
  NPD
• Amina Bhatia, MD

  • Pediatric Surgery Physician
  • Atlanta, GA
  • NPI 1528151859
  NPD
• Natalie Victoria Roebuck Bishop, M.D.

  • Pediatric Critical Care Medicine Physician
  • Atlanta, GA
  • NPI 1629331004

  Pediatric Critical Care Medicine

  NPD
• Kelsey Bohm, PAA

  • Anesthesiologist Assistant
  • Atlanta, GA
  • NPI 1245869551
  NPD
• Elise Boudreaux, CAA

  • Anesthesiologist Assistant
  • Atlanta, GA
  • NPI 1619673027
  NPD
• Robert Bruce Jr., MD

  • Orthopaedic Surgery Physician
  • Atlanta, GA
  • NPI 1972605681
  NPD
• John Michael Buchanan, DO

  • Sports Medicine (Family Medicine) Physician
  • Dacula, GA
  • NPI 1982679684
  NPD

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736985600000",
    "number": "1811041452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1575 NE EXPRESSWAY",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 CLIFTON RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221060",
            "telephone_number": "404-785-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EGLESTON PEDIATRIC GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A",
        "authorized_official_last_name": "CODY",
        "authorized_official_first_name": "LOUETTA",
        "authorized_official_title_or_position": "MANAGER, PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "404-785-7876"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0222X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Collin J Eggebrecht, P.T.
• Erin McFarling Eggebrecht, DPT
• Shahin Eghrari
• Ernest Eglen III, LCSW
• Egleston Children'S Hospital at Emory University, Inc.
• Everette K Egun, PHARM.D.
• Ehca Dunwoody, LLC
• Ehca Dunwoody, LLC
• Ehi Anesthesia Associates, LLC.
• Ehi Anesthesia Services, LLC.

• All providers in Atlanta, GA
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; 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.