Organization Active NPI

Sunrise Pediatric Neurology

  • Child & Adolescent Psychiatry Physician
  • Marietta, GA
National Provider Identifier
1841732138
Registry record updated Nov 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
Legal business name
SUNRISE PEDIATRIC NEUROLOGY
Practice address
3417 Canton Rd
Building1
Marietta, GA 30066-2896
Phone
(678) 606-5700
NPI assigned
Nov 17, 2016
Last updated
Nov 17, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2016

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

Authorized official

Name
Cherise FrazierNPI 1689833683
Title
Owner
Phone
(678) 606-5700

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X NU Primary

Addresses

Primary practice location

3417 Canton Rd
Building1
Marietta, GA 30066-2896

Mailing address

3417 Canton Rd
Building 1
Marietta, GA 30066-2896
Phone (678) 606-5700

National Provider Directory

National Provider Directory

Locations

3417 Canton Rd
Bldg 1
Marietta, GA 30066
Phone (678) 606-5700

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1479340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479340800000",
    "number": "1841732138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3417 CANTON RD",
            "address_2": "BUILDING 1",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300662896",
            "telephone_number": "678-606-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3417 CANTON RD",
            "address_2": "BUILDING1",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300662896",
            "telephone_number": "678-606-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNRISE PEDIATRIC NEUROLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-17",
        "last_updated": "2016-11-17",
        "status": "A",
        "authorized_official_last_name": "FRAZIER",
        "authorized_official_first_name": "CHERISE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-606-5700"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2016; 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.