Active NPI
Cathy Hyun Pak, M.D.
- Pediatrics Physician
- Dalton, GA
National Provider Identifier
1871609511
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 040975
- Practice address
- 711 Shields Rd
Dalton, GA 30720-5013 - Phone
- (706) 278-6628
- Fax
- (706) 278-6650
- NPI assigned
- Aug 23, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 040975 | GA | Primary |
Addresses
Primary practice location
711 Shields Rd
Dalton, GA 30720-5013
Mailing address
2411 Crow Valley Rd NW
Dalton, GA 30720-6921
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
| License | State | Type | Specialty |
|---|---|---|---|
| 040975 | GA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peds Care P.C. | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- drpak@pedscare.opdirect.net
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1871609511",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2411 CROW VALLEY RD NW",
"city": "DALTON",
"state": "GA",
"postal_code": "307206921"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "711 SHIELDS RD",
"city": "DALTON",
"state": "GA",
"postal_code": "307205013",
"telephone_number": "706-278-6628",
"fax_number": "706-278-6650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAK",
"first_name": "CATHY",
"middle_name": "HYUN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "GA",
"license": "040975",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dalton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.