Active NPI
Grayson Pediatrics, LLC
- Pediatrics Physician
- Loganville, GA
National Provider Identifier
1831500370
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 057218
- Legal business name
- GRAYSON PEDIATRICS, LLC
- Practice address
- 297 Cooper Rd
Loganville, GA 30052-2518 - Phone
- (678) 381-2630
- Fax
- (678) 381-2627
- NPI assigned
- May 19, 2014
- Last updated
- Nov 5, 2026
- 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
- Radly Opeka
- Title
- Ceo
- Phone
- (678) 381-2630
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 057218 | GA | Primary |
| Pediatric Nurse Practitioner | 363LP0200X | RN154025 | GA |
Addresses
Primary practice location
297 Cooper Rd
Loganville, GA 30052-2518
Mailing address
297 Cooper Rd
Loganville, GA 30052-2518
Phone (678) 381-2630
Other practice location 1
80 Parker Dr
Monroe, GA 30656-4747
Phone (678) 381-2630
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | grayson.office.1@28046.direct.athenahealth.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
National Provider Directory
National Provider Directory- Tax ID family
- Grayson Pediatrics LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Pediatrics Physician
- Grayson, GA
- NPI 1083026066
Locations
297 Cooper Rd
Loganville, GA 30052
Phone (678) 381-2627
80 Parker Dr
Monroe, GA 30656
Phone (678) 381-2630
Interoperability endpoints
- grayson.office.1@28046.direct.athenahealth.com
Practitioners & affiliated clinicians
Practitioners 20
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.
-
- Pediatrics Physician
- Loganville, GA
- NPI 1679759096
-
- Pediatrics Physician
- Loganville, GA
- NPI 1932119377
-
- Registered Nurse
- Loganville, GA
- NPI 1972382240
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400457600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1793836800000",
"number": "1831500370",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "297 COOPER RD",
"city": "LOGANVILLE",
"state": "GA",
"postal_code": "300522518",
"telephone_number": "678-381-2630",
"fax_number": "678-381-2627"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "297 COOPER RD",
"city": "LOGANVILLE",
"state": "GA",
"postal_code": "300522518",
"telephone_number": "678-381-2630",
"fax_number": "678-381-2627"
}
],
"practiceLocations": [
{
"address_1": "80 Parker Dr",
"address_purpose": "LOCATION",
"city": "Monroe",
"state": "GA",
"postal_code": "306564747",
"country_code": "US",
"telephone_number": "678-381-2630",
"fax_number": "678-381-2627",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "GRAYSON PEDIATRICS, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2014-05-19",
"last_updated": "2026-11-05",
"certification_date": "2026-11-05",
"status": "A",
"authorized_official_last_name": "OPEKA",
"authorized_official_first_name": "RADLY",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "678-381-2630"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Pediatrics",
"state": "GA",
"license": "057218",
"primary": true
},
{
"code": "363LP0200X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Pediatrics",
"state": "GA",
"license": "RN154025",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "grayson.office.1@28046.direct.athenahealth.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "297 Cooper Rd",
"city": "Loganville",
"state": "GA",
"country_code": "US",
"postal_code": "300522518",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Loganville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.