Organization Active NPI

Pediatric Wellness Associates LLLP

  • Pediatrics Physician
  • Roswell, GA
National Provider Identifier
1902433832
Registry record updated Mar 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PEDIATRIC WELLNESS ASSOCIATES LLLP
Practice address
1240 Upper Hembree Rd Ste a
Roswell, GA 30076-0914
Phone
(888) 381-8556
NPI assigned
Mar 23, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2020

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

Authorized official

Name
Dr. Maia Alees Walton, MD
Title
Medical Director
Phone
(888) 381-8556

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary
Pediatric Neurodevelopmental Disabilities PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0008X

Addresses

Primary practice location

1240 Upper Hembree Rd Ste a
Roswell, GA 30076-0914

Mailing address

1240 Upper Hembree Rd Ste a
Roswell, GA 30076-0914
Phone (888) 381-8556

National Provider Directory

National Provider Directory

Locations

1240 Upper Hembree Rd
Ste A
Roswell, GA 30076
Phone (404) 751-3693

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1584921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584921600000",
    "number": "1902433832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 UPPER HEMBREE RD STE A",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300760914",
            "telephone_number": "888-381-8556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 UPPER HEMBREE RD STE A",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300760914",
            "telephone_number": "888-381-8556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC WELLNESS ASSOCIATES LLLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-23",
        "last_updated": "2020-03-23",
        "certification_date": "2020-03-23",
        "status": "A",
        "authorized_official_last_name": "WALTON",
        "authorized_official_first_name": "MAIA",
        "authorized_official_middle_name": "ALEES",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "888-381-8556",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2080P0008X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Neurodevelopmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2020; 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.