NPIMap

Organization Active NPI

Pediatric Cardiology Services LLC

  • Pediatric Cardiology Physician
  • Atlanta, GA
National Provider Identifier
1922269794
Registry record updated Jun 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
043298 Issued in GA
Legal business name
PEDIATRIC CARDIOLOGY SERVICES LLC
Practice address
980 Johnson Ferry Rd NE
Suite 560
Atlanta, GA 30342-1626
Phone
(770) 995-6684
Fax
(770) 995-7631
NPI assigned
Jun 24, 2008
Last updated
Jun 24, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2008

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

Authorized official

Name
Ms. Kim Woody, RMM
Title
Practice Administrator
Phone
(770) 995-6684

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 043298 GA Primary

Addresses

Primary practice location

980 Johnson Ferry Rd NE
Suite 560
Atlanta, GA 30342-1626

Mailing address

500 Medical Center Blvd
Suite 340
Lawrenceville, GA 30045-8708
Phone (770) 995-6684

Other identifiers 2

IdentifierTypeStateIssuer
00740891AMedicaidGA
000326873GMedicaidGA

National Provider Directory

National Provider Directory
Tax ID family
Pediatric Cardiology Services LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

980 Johnson Ferry Rd
Ste 560
Sandy Springs, GA 30342
Phone (404) 943-1341

NPI Registry JSON

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

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214265600000",
    "number": "1922269794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 MEDICAL CENTER BLVD",
            "address_2": "SUITE 340",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300458708",
            "telephone_number": "770-995-6684",
            "fax_number": "770-995-7631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 JOHNSON FERRY RD NE",
            "address_2": "SUITE 560",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421626",
            "telephone_number": "770-995-6684",
            "fax_number": "770-995-7631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC CARDIOLOGY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-24",
        "last_updated": "2008-06-24",
        "status": "A",
        "authorized_official_last_name": "WOODY",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "770-995-6684",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RMM"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "GA",
            "license": "043298",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00740891A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000326873G",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2008; 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.