GRAYSON PEDIATRICS LLC NPI 1831500370

NPI Information

  • NPI: 1831500370
  • Provider Name: GRAYSON PEDIATRICS, LLC
  • Classification: Pediatrics - 208000000X
  • Entity Type: Organization
  • CLIA Number: 11D2291544
  • Address: 297 COOPER RD
    LOGANVILLE, GA
    ZIP 30052
  • Phone: (678) 381-2630

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NPI Details

GRAYSON PEDIATRICS, LLC is a pediatrics in Loganville, GA. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. GRAYSON PEDIATRICS, LLC NPI is 1831500370. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

297 COOPER RD
LOGANVILLE, GA
ZIP 30052-518
Phone: (678) 381-2630
Fax: (678) 381-2627

The provider's authorized official is Julie A Opeka .
The authorized official title is Np, Cfo and has the following contact phone number (678) 381-2630.

The CLIA number assigned to this NPI record is 11D2291544 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/19/2014 and was last updated on 7/29/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208000000XPediatrics057218GEORGIAYes
2363LP0200XNurse PractitionerPediatricsRN154025GEORGIANo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1003172811AMEDICAIDGEORGIA
21831365964MEDICAIDGEORGIA
3003109575EMEDICAIDGEORGIA
4003172811DMEDICAIDGEORGIA
5003191294BMEDICAIDGEORGIA
6003215265AMEDICAIDGEORGIA
7452405206MMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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