Individual provider Active NPI

Ishrat A Hussain, MD

  • Pediatrics Physician
  • Stockbridge, GA
National Provider Identifier
1851474795
Registry record updated Oct 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
048650 Issued in GA
Practice address
125 Eagles Pointe Pkwy
Ste 120
Stockbridge, GA 30281-6379
Phone
(770) 474-6969
Fax
(770) 474-6996
NPI assigned
Oct 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 048650 GA Primary

Addresses

Primary practice location

125 Eagles Pointe Pkwy
Ste 120
Stockbridge, GA 30281-6379

Mailing address

125 Eagles Pointe Pkwy
Ste 120
Stockbridge, GA 30281-6379
Phone (770) 474-6969

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
048650GAMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382054400000",
    "number": "1851474795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 EAGLES POINTE PKWY",
            "address_2": "STE 120",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302816379",
            "telephone_number": "770-474-6969",
            "fax_number": "770-474-6996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 EAGLES POINTE PKWY",
            "address_2": "STE 120",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302816379",
            "telephone_number": "770-474-6969",
            "fax_number": "770-474-6996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSSAIN",
        "first_name": "ISHRAT",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2013-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "048650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockbridge, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2013; 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.