Individual provider Active NPI

Jessica Tuttle, M.D.

  • Pediatrics Physician
  • Atlanta, GA
National Provider Identifier
1841521754
Registry record updated Jan 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
034970 Issued in GA
Practice address
424 Decatur St SE
Atlanta, GA 30312-1848
Phone
(404) 921-4544
Fax
(678) 843-8576
NPI assigned
Jan 18, 2010
Last updated
Jan 18, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 034970 GA
Pediatrics Physician 208000000X 034970 GA Primary

Addresses

Primary practice location

424 Decatur St SE
Atlanta, GA 30312-1848

Mailing address

2 Peachtree St NW
Suite 14-105
Atlanta, GA 30303-3141
Phone (404) 921-4544

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
034970GAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1263772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263772800000",
    "number": "1841521754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 PEACHTREE ST NW",
            "address_2": "SUITE 14-105",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303033141",
            "telephone_number": "404-921-4544",
            "fax_number": "678-843-8576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 DECATUR ST SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303121848",
            "telephone_number": "404-921-4544",
            "fax_number": "678-843-8576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUTTLE",
        "first_name": "JESSICA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-18",
        "last_updated": "2010-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "034970",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "034970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2010; 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.