PEDSMD LLC NPI 1659064921

NPI Information

  • NPI: 1659064921
  • Provider Name: PEDSMD LLC
  • Classification: Clinic/Center - 261QU0200X
  • Specialization: Urgent Care
  • Entity Type: Organization
  • CLIA Number: 11D2291828
  • Address: 4941 S OLD PEACHTREE RD STE B
    PEACHTREE CORNERS, GA
    ZIP 30092
  • Phone: (678) 960-8316

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NPI Details

PEDSMD LLC is an urgent care clinic center in Peachtree Corners, GA. PEDSMD LLC NPI is 1659064921. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4941 S OLD PEACHTREE RD STE B
PEACHTREE CORNERS, GA
ZIP 30092-495
Phone: (678) 960-8316
Fax: (678) 550-6569

The provider's authorized official is Fabian Chang .
The authorized official title is Md/ceo and has the following contact phone number (678) 960-8316.

The CLIA number assigned to this NPI record is 11D2291828 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 6/1/2023 and was last updated on 6/1/2023.

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
1208000000XPediatricsNo
2261QU0200XClinic/CenterUrgent CareYes

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: 11/21/2025

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