Daffodil Pediatrics and Family Medicine

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

DAFFODIL PEDIATRICS AND FAMILY MEDICINE

Practice address

4905 Courtney Drive
Forest Park, GA 30297

Phone

(404) 366-3636

Fax

(404) 362-0808

NPI assigned

Feb 2, 2012

Organization subpart

No

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

Authorized official

Name

Jon Frederick Stachelrodt

Title

Ceo

Phone

(310) 429-8614

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Keyana Cardoza

  • Physician Assistant
  • Decatur, GA
  • NPI 1518711985
  NPD (past)
• Fahimot Oyinlola Faduyile, M.D.

  • Pediatrics Physician
  • Forest Park, GA
  • NPI 1386051712
  NPD (past)
• Deasia Diaz Henderson, PA-C

  • Physician Assistant
  • Atlanta, GA
  • NPI 1629553383
  NPD (past)
• Amisa Jiwani, APRN

  • Pediatric Nurse Practitioner
  • Forest Park, GA
  • NPI 1407641764
  NPD (past)
• Vaughnette M Jones, MD

  • Pediatrics Physician
  • Forest Park, GA
  • NPI 1811069909
  NPD (past)
• Abigail Kamishlian, M.D.

  • Pediatrics Physician
  • Forest Park, GA
  • NPI 1477537322
  NPD (past)
• Maya Tiffany Jacqueline King, CPNP

  • Pediatric Nurse Practitioner
  • Atlanta, GA
  • NPI 1538702170
  NPD (past)
• Dorothy Nicole Lake, CPNP

  • Pediatric Nurse Practitioner
  • Carrollton, GA
  • NPI 1528438538
  NPD (past)
• Shweta Navneet Maheshwari, D.O.

  • Pediatrics Physician
  • Forest Park, GA
  • NPI 1952689200
  NPD (past)
• Claudine Moma Malonga, DNP, C-PNP-PC

  • Pediatric Nurse Practitioner
  • Forest Park, GA
  • NPI 1528869807
  NPD (past)
• Gloria C. Price, NURSE PRACTITIONER

  • Nurse Practitioner
  • Atlanta, GA
  • NPI 1225468184
  NPD (past)
• Mar'Quenda Sanders, MD

  • Pediatrics Physician
  • Lithonia, GA
  • NPI 1386103539
  NPD (past)

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

{
    "created_epoch": "1328140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379289600000",
    "number": "1851663124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4905 COURTNEY DRIVE",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "30297",
            "telephone_number": "404-366-3636",
            "fax_number": "404-362-0808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4905 COURTNEY DRIVE",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "30297",
            "telephone_number": "404-366-3636",
            "fax_number": "404-362-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAFFODIL PEDIATRICS AND FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-02",
        "last_updated": "2013-09-16",
        "status": "A",
        "authorized_official_last_name": "STACHELRODT",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "FREDERICK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-429-8614"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crisp & Associates II, LLC
• Crisp & Associates III, LLC
• Cross Keys Counseling Center, Inc.
• Angel J Cruz, DC
• Crystal Home Care Services LLC
• Oanh Xuan Dam, M.D.
• Damc Dental and Medical Resources LLC
• Jamal Davis, PHARM. D
• Brandon Dennis, PHARMD
• Ramatoulaye Diallo

• Pediatrics Physician in Forest Park, GA
• Providers in Forest Park, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.