Active NPI
Olabisi Pearse, MD
- Pediatrics Physician
- Duluth, GA
National Provider Identifier
1881762623
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 49717
- Practice address
- 2660 Satellite Blvd
Duluth, GA 30096-5803 - Phone
- (404) 785-8330
- Fax
- (404) 785-8390
- NPI assigned
- Dec 1, 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 | 49717 | GA | Primary |
Addresses
Primary practice location
2660 Satellite Blvd
Duluth, GA 30096-5803
Mailing address
2660 Satellite Blvd
Duluth, GA 30096-5803
Phone (404) 785-8330
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | choa@choa.gadirect.net |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160513000254 | GA | Order and Referring Only - Pediatric Medicine | 6608165758 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 49717 | GA | MD | Pediatrics Physician |
Interoperability endpoints
- opearse6095@choa.gadirect.net
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654473600000",
"number": "1881762623",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2660 SATELLITE BLVD",
"city": "DULUTH",
"state": "GA",
"postal_code": "300965803",
"telephone_number": "404-785-8330",
"fax_number": "404-785-8390"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2660 SATELLITE BLVD",
"city": "DULUTH",
"state": "GA",
"postal_code": "300965803",
"telephone_number": "404-785-8330",
"fax_number": "404-785-8390"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEARSE",
"first_name": "OLABISI",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-01",
"last_updated": "2022-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "GA",
"license": "49717",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "choa@choa.gadirect.net",
"affiliation": "N",
"address_1": "2660 Satellite Blvd",
"city": "Duluth",
"state": "GA",
"country_code": "US",
"postal_code": "300965803",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Duluth, GA
- Peachtree Christian Health, Inc.
- Peachtree Orthopaedic Clinic
- Peachtree Orthopaedic Clinic, PC
- Peachtree Orthopaedic Clinic, PC
- Peachtree Pelvic Health LLC
- Teleigha L Peavy
- Kranti Venkata Peddada
- Pediatric Associates of North Atlanta, P.C.
- Pediatric Endocrine Specialists of Georgia
- Chantal M Peele, LPC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.