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Contact Information

CRESCENT PEDIATRICS
2925 PREMIERE PKWY
SUITE 140
DULUTH, GA30097
 Phone: 770-495-6222
 Fax: 770-495-9959
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
 

Legal Medicine

173000000X
Indicates primary specialty

NPI Profile & details for CRESCENT PEDIATRICS

NPI # 1851494447
LBN Legal business name CRESCENT PEDIATRICS
Authorized official WILLIAM MONEIT - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 09/07/2006
Last updated 02/01/2011 - About 15 years ago
Identifiers
GA License # 034204
GA Medicaid 000449611C
GA Medicaid 85001694G
Other 10037067 AMERIGROUP
Other 912801 CIGNA
Other 72291 COVENTRY
Other 1207077 UNITED HEALTHCARE
Other 313452 WELLCARE
GA Other 4308928 AETNA
GA Other 52062819002 BC
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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