Covenant Care Pediatrics PC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

COVENANT CARE PEDIATRICS PC

Practice address

245 Country Club Dr BLDG 200a
Stockbridge, GA 30281-7212

Phone

(770) 389-4543

Fax

(770) 474-0566

NPI assigned

Feb 21, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Patrick Pulliam, MDNPI 1215944863

Title

President

Phone

(770) 389-4543

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 6

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

• Patrick Neal Pulliam, M.D.

  • Pediatrics Physician
  • Stockbridge, GA
  • NPI 1215944863
  NPD Authorized official
• Megan Byrne, CPNP

  • Pediatric Nurse Practitioner
  • Decatur, GA
  • NPI 1144780263
  NPD (past)
• Stephanie Nicole Clark

  • Family Nurse Practitioner
  • Stockbridge, GA
  • NPI 1760002893
  NPD (past)
• Jessica Haynie

  • Pediatric Nurse Practitioner
  • Stockbridge, GA
  • NPI 1982182374
  NPD (past)
• Rebecca Anne Smith, CPNP

  • Pediatric Nurse Practitioner
  • Stockbridge, GA
  • NPI 1366117657
  NPD (past)
• Grace Underhill Solms, CPNP-PC

  • Pediatric Nurse Practitioner
  • Bentonville, AR
  • NPI 1114492329
  NPD (past)

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513555200000",
    "number": "1902941503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 COUNTRY CLUB DR BLDG 200A",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817212",
            "telephone_number": "770-389-4543",
            "fax_number": "770-474-0566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 COUNTRY CLUB DR BLDG 200A",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817212",
            "telephone_number": "770-389-4543",
            "fax_number": "770-474-0566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT CARE PEDIATRICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2017-12-18",
        "status": "A",
        "authorized_official_last_name": "PULLIAM",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-389-4543",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melani P Cornelius-Sanders, M.D.
• Karyssa Coston, NP
• Don Cotton, LPC
• Jesse William Couk, M.D.
• Countryside Hospice Care, Inc
• Joseph Paul Coviello, DPT
• Shannon Larissa Cox, PA-C
• Chentiesha Latrice Cozart, DPT
• Cranial Technologies, Inc.
• Create Your Life Doula and Coaching Services

• Pediatrics Physician in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2017; 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.