Active NPI
Egleston Pediatric Group
- Pediatrics Physician
- Atlanta, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- 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
- Last updated
- Jan 16, 2025
- Organization subpart
- No
NPPES NPI Registry
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
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | Primary | ||
| Pediatric Critical Care Medicine Physician | 2080P0203X | |||
| Pediatric Emergency Medicine (Pediatrics) Physician | 2080P0204X | |||
| Pediatric Endocrinology Physician | 2080P0205X | |||
| Medical Physician Assistant | 363AM0700X | |||
| Pediatric Nurse Practitioner | 363LP0200X | |||
| Critical Care Pediatric Nurse Practitioner | 363LP0222X | |||
| Primary Care Nurse Practitioner | 363LP2300X |
Addresses
Primary practice location
1405 Clifton Rd NE
Atlanta, GA 30322-1060
Mailing address
1575 NE Expressway
Atlanta, GA 30329-2401
National Provider Directory
National Provider DirectoryLocations
970 Joe Frank Harris Pkwy SE
Ste 106
Cartersville, GA 30120
4961 Buford Hwy
Chamblee, GA 30341
Phone (470) 509-4648
580 Atlanta Rd
Ste 231
Cumming, GA 30040
125 Clairemont Ave
#2520
Decatur, GA 30030
3802 Satellite Blvd
Duluth, GA 30096
4891 Ashford Dunwoody Rd
Dunwoody, GA 30338
3618 Sandy Plains Rd
Marietta, GA 30066
Phone (770) 677-3513
50 Plaza Way NW
Ste C
Marietta, GA 30060
Practitioners & affiliated clinicians
Practitioners 216
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Hematology (Pathology) Physician
- Atlanta, GA
- NPI 1912246307
-
- Sports Medicine (Family Medicine) Physician
- Buford, GA
- NPI 1245291616
-
- Pediatric Infectious Diseases Physician
- Atlanta, GA
- NPI 1427250661
-
- Anesthesiology Physician
- Atlanta, GA
- NPI 1962676312
-
- Pediatric Hematology & Oncology Physician
- Atlanta, GA
- NPI 1235171562
-
- Pediatric Surgery Physician
- Atlanta, GA
- NPI 1528151859
-
- Pediatric Critical Care Medicine Physician
- Atlanta, GA
- NPI 1629331004
-
- Anesthesiologist Assistant
- Atlanta, GA
- NPI 1245869551
-
- Anesthesiologist Assistant
- Atlanta, GA
- NPI 1619673027
-
- Orthopaedic Surgery Physician
- Atlanta, GA
- NPI 1972605681
-
- Sports Medicine (Family Medicine) Physician
- Dacula, GA
- NPI 1982679684
NPI Registry JSON
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": []
}
Other providers in Atlanta, GA
- 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 (Emory Dunwoody Medical Center)
- Ehca Dunwoody, LLC (Emory Dunwoody Medical Center)
- Ehi Anesthesia Associates, LLC.
- Ehi Anesthesia Services, LLC.
Sources for this page
- 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.