Individual provider Active NPI

Faye Eaton, MD

  • Pediatrics Physician
  • Macon, GA
National Provider Identifier
1902999162
Registry record updated Jun 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
16176 Issued in GA
Practice address
682 Hemlock St
Suite 290
Macon, GA 31201-6883
Phone
(478) 743-8052
Fax
(478) 743-0035
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 16176 GA Primary
Pediatrics Physician 208000000X 26744 NC

Addresses

Primary practice location

682 Hemlock St
Suite 290
Macon, GA 31201-6883

Mailing address

682 Hemlock St
Suite 290
Macon, GA 31201-6883
Phone (478) 743-8052

Other identifiers 1

IdentifierTypeStateIssuer
000155075BMedicaidGA

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

LicenseStateTypeSpecialty
16176GAMDPediatrics Physician
26744NCMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308182400000",
    "number": "1902999162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "682 HEMLOCK ST",
            "address_2": "SUITE 290",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312016883",
            "telephone_number": "478-743-8052",
            "fax_number": "478-743-0035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "682 HEMLOCK ST",
            "address_2": "SUITE 290",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312016883",
            "telephone_number": "478-743-8052",
            "fax_number": "478-743-0035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EATON",
        "first_name": "FAYE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2011-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "16176",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "26744",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000155075B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2011; 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.