Active NPI
Georgina Peacock, M.D.
- Developmental - Behavioral Pediatrics Physician
- Alanta, GA
National Provider Identifier
1982635546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental - Behavioral Pediatrics Physician
- License
- 04-29399
- Practice address
- 1600 Clifton Road Mail Stop E-87
Centers for Disease Control and Prevention
Alanta, GA 30333 - Phone
- (404) 498-4347
- Fax
- (404) 498-3050
- NPI assigned
- Jul 5, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental - Behavioral Pediatrics Physician | 2080P0006X | 04-29399 | KS | Primary |
Addresses
Primary practice location
1600 Clifton Road Mail Stop E-87
Centers for Disease Control and Prevention
Alanta, GA 30333
Mailing address
220 Huron St
Decatur, GA 30030-1865
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04-29399 | KS | MD | Developmental - Behavioral Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194912000000",
"number": "1982635546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "220 HURON ST",
"city": "DECATUR",
"state": "GA",
"postal_code": "300301865"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 CLIFTON ROAD MAIL STOP E-87",
"address_2": "CENTERS FOR DISEASE CONTROL AND PREVENTION",
"city": "ALANTA",
"state": "GA",
"postal_code": "30333",
"telephone_number": "404-498-4347",
"fax_number": "404-498-3050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEACOCK",
"first_name": "GEORGINA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-05",
"last_updated": "2007-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0006X",
"taxonomy_group": "",
"desc": "Pediatrics, Developmental - Behavioral Pediatrics",
"state": "KS",
"license": "04-29399",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.