NPIMap

Organization Active NPI

Peds and Parents Family Care, LLC

  • Family Medicine Physician
  • Kingsland, GA
National Provider Identifier
1912115452
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
54592 Issued in GA
Legal business name
PEDS AND PARENTS FAMILY CARE, LLC
Practice address
124 Andrews Way
Suite B
Kingsland, GA 31548-6860
Phone
(912) 729-7007
Fax
(912) 729-3627
NPI assigned
May 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mary Lee Carter, M.D.NPI 1427000165
Title
President
Phone
(912) 729-7007

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 54592 GA Primary

Addresses

Primary practice location

124 Andrews Way
Suite B
Kingsland, GA 31548-6860

Mailing address

124 Andrews Way
Suite B
Kingsland, GA 31548-6860
Phone (912) 729-7007

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210407001696 GA Part B Supplier - Clinic/Group Practice 0749697878 Receives reassigned benefits from 4 practitioners
Practice locations: Saint Marys, GA

National Provider Directory

National Provider Directory

Locations

124 Andrews Way
Saint Marys, GA 31558
Phone (912) 729-7007

124 Andrews Way
Ste B
Saint Marys, GA 31558
Phone (912) 729-7007

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14356/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 7

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": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1912115452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 ANDREWS WAY",
            "address_2": "SUITE B",
            "city": "KINGSLAND",
            "state": "GA",
            "postal_code": "315486860",
            "telephone_number": "912-729-7007",
            "fax_number": "912-729-3627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 ANDREWS WAY",
            "address_2": "SUITE B",
            "city": "KINGSLAND",
            "state": "GA",
            "postal_code": "315486860",
            "telephone_number": "912-729-7007",
            "fax_number": "912-729-3627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDS AND PARENTS FAMILY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "912-729-7007",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "54592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsland, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.