Pediatric Endocrine Associates, PC

Primary specialty

Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X

License

25935 Issued in GA

Legal business name

PEDIATRIC ENDOCRINE ASSOCIATES, PC

Practice address

1100 Lake Hearn Dr NE
Suite 350
Atlanta, GA 30342-1523

Phone

(404) 255-0015

Fax

(404) 845-3080

NPI assigned

Nov 9, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Mark A. Spangler

Title

Practice Administrator

Phone

(404) 255-1267

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1194566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195171200000",
    "number": "1932389608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 LAKE HEARN DR NE",
            "address_2": "SUITE 350",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421523",
            "telephone_number": "404-255-0015",
            "fax_number": "404-845-3080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 LAKE HEARN DR NE",
            "address_2": "SUITE 350",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421523",
            "telephone_number": "404-255-0015",
            "fax_number": "404-845-3080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ENDOCRINE ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-09",
        "last_updated": "2007-11-16",
        "status": "A",
        "authorized_official_last_name": "SPANGLER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "404-255-1267",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "GA",
            "license": "25935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00313365A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18949",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00709541A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pediatric Audiology of Atlanta
• Pediatric Cardiology Services LLC
• Pediatric Developmental Services
• Pediatric Ear, Nose, & Throat of Atlanta, PC
• Pediatric Endocrine Associates II LLC
• Pediatric Eye Consultants of Atlanta, LLC
• Pediatric Hair Solutions Corporation
• Pediatric Hospice and Palliative Care of Georgia LLC
• Pediatric Neurosurgery Associates @ Children'S Healthcare of Atlanta
• Pediatric Orthopaedic Associates

• Pediatric Endocrinology Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Pediatric Endocrinology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2007; 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.