NPIMap

Organization Active NPI

Scottish Rite Childrens Medical Ctr

Doing business as Children's Healthcare of Atlanta at Scottish Rite

  • Children's Hospital
  • Atlanta, GA
National Provider Identifier
1922178789
Registry record updated Feb 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Children's HospitalTaxonomy code 282NC2000X
License
060-303 Issued in GA
Legal business name
SCOTTISH RITE CHILDRENS MEDICAL CTR
Doing business as
Children's Healthcare of Atlanta at Scottish Rite
Practice address
1001 Johnson Ferry Rd NE
Atlanta, GA 30342-1605
Phone
(404) 785-5252
NPI assigned
Nov 9, 2006
Last updated
Feb 23, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2023

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

Authorized official

Name
Louetta Cody
Title
MGR, Provider Enrollment
Phone
(404) 785-7876

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Children's Hospital 282NC2000X 060-303 GA Primary

Addresses

Primary practice location

1001 Johnson Ferry Rd NE
Atlanta, GA 30342-1605

Mailing address

1575 Northeast Expy NE
Brookhaven, GA 30329-2401
Phone (404) 785-7876

Other identifiers 4

IdentifierTypeStateIssuer
000001636AMedicaidGA
1000062OtherGAAMERIGROUP PROVIDER ID
21316OtherGAWELLCARE PROVIDER ID
000001636AOtherGAPEACH STATE PROVIDER ID

Other names 1

  • Children's Healthcare of Atlanta at Scottish Rite Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041013000409 GA Part A Provider - Hospital 4981506581 Practice locations: Canton, GA; Stockbridge, GA; Snellville, GA; Smyrna, GA; Lawrenceville, GA; Kennesaw, GA; Fayetteville, GA; Duluth, GA…

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1922178789. Details of each certification follow.

Hospital certification: CCN 113301

Legal name
SCOTTISH RITE CHILDRENS MEDICAL CENTER
Doing business as
CHILDREN'S HEALTHCARE OF ATLANTA AT SCOTTISH RITE
Certification status
Active
Provider type (POS)
Hospital – Children’s
Participating since
May 20, 1996
Last certification
Apr 25, 2025
Beds
234
Ownership / control type
Other
Organization structure
CorporationNon-profit
Incorporated
Apr 10, 1915 in GA
Enrollment address
1001 Johnson Ferry Road
Atlanta, GA 30342-1605
Main/Primary Hospital Location
Hospital subgroups
Children’s

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospital

Medicare Care Compare
Listed as
Children's Healthcare of Atlanta at Scottish RiteCCN 113301 · All quality measures
Type
Childrens
Ownership
Voluntary non-profit - Other
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Scottish Rite Children's Medical Center11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3155 North Point Pkwy
Ste A150
Alpharetta, GA 30005

3300 Old Milton Pkwy
Ste 370
Alpharetta, GA 30005

3795 Mansell Rd
Alpharetta, GA 30022
Phone (404) 785-8540

1405 Clifton Rd NE
#1
Atlanta, GA 30322

1547 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 712-3930

1554 Riverstone Pkwy
Canton, GA 30114

2270 Duluth Highway 120
Ste 200
Duluth, GA 30097
Phone (404) 785-8387

625 Big Shanty Rd NW
Ste 100
Kennesaw, GA 30144

5445 Meridian Mark Rd
Ste 140
Sandy Springs, GA 30342

5445 Meridian Mark Rd
Ste 200
Sandy Springs, GA 30342
Phone (404) 785-2691

5445 Meridian Mark Rd
Ste 290
Sandy Springs, GA 30342
Phone (404) 785-5699

5455 Meridian Mark Rd
Ste 26
Sandy Springs, GA 30342

5455 Meridian Mark Rd
Ste 260
Sandy Springs, GA 30342

5461 Meridian Mark Rd
Ste 180
Sandy Springs, GA 30342
Phone (404) 785-2849

5461 Meridian Mark Rd
Ste 300
Sandy Springs, GA 30342
Phone (404) 785-3750

5461 Meridian Mark Rd
Ste 400
Sandy Springs, GA 30342
Phone (404) 785-1112

5670 Peachtree Dunwoody Rd
Ste 1150
Sandy Springs, GA 30342

975 Johnson Ferry Rd
Ste 108
Sandy Springs, GA 30342

1675 Cumberland Pkwy SE
Ste 305
Smyrna, GA 30080
Phone (404) 785-4271

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Scottish Rite Childrens Medical Center Organization, Atlanta, GA Non-profit Operational/Managerial Control May 18, 2015 100%
Children's Healthcare of Atlanta, Inc Organization, Atlanta, GA Non-profit 5% Or Greater Direct Ownership Interest Feb 1, 1998 100%
Donna Hyland Individual Corporate OfficerChief Executive Officer Mar 4, 1998
Corporate DirectorChief Executive Officer Jun 1, 2008
W-2 Managing EmployeeChief Executive Officer May 18, 2015
Ruth Fowler Individual Corporate OfficerChief Financial Officer Jul 1, 2002
Corporate DirectorChief Financial Officer May 20, 2014
W-2 Managing EmployeeChief Financial Officer Aug 26, 2010

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 170

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 170

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677110400000",
    "number": "1922178789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1575 NORTHEAST EXPY NE",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303292401",
            "telephone_number": "404-785-7876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 JOHNSON FERRY RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421605",
            "telephone_number": "404-785-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTTISH RITE CHILDRENS MEDICAL CTR",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A",
        "authorized_official_last_name": "CODY",
        "authorized_official_first_name": "LOUETTA",
        "authorized_official_title_or_position": "MGR, PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "404-785-7876"
    },
    "taxonomies": [
        {
            "code": "282NC2000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Children",
            "state": "GA",
            "license": "060-303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000001636A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP PROVIDER ID",
            "identifier": "1000062",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE PROVIDER ID",
            "identifier": "21316",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEACH STATE PROVIDER ID",
            "identifier": "000001636A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Children's Healthcare of Atlanta at Scottish Rite",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Children's Healthcare of Atlanta at Scottish Rite",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.