OrganizationActive
Locust Grove Pediatrics
NPI 1174693519 · Pediatrics Physician · Locust Grove, GA
Locust Grove Pediatrics is a Pediatrics Physician organization in Locust Grove, GA (NPI 1174693519).
Provider details
- NPI number
- 1174693519
- Entity type
- Organization
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- John Mynatt, Owner(678) 583-5437
- License
- 041469 (GA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
5040 Bill Gardner Pkwy
Suite 100
Locust Grove, GA 30248-3645
Phone: (678) 583-5437
Fax: (678) 583-5484
Street-level locationGet directions
Mailing address
5040 Bill Gardner Pkwy
Locust Grove, GA 30248-3645
Registry dates
- Enumerated
- 2006-11-09
- Last updated
- 2007-09-10
Frequently asked questions
- What is Locust Grove Pediatrics's NPI number?
- Locust Grove Pediatrics's National Provider Identifier (NPI) is 1174693519, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Locust Grove Pediatrics?
- Locust Grove Pediatrics is classified in the NPPES registry as Pediatrics Physician (Allopathic & Osteopathic Physicians).
- Where is Locust Grove Pediatrics located?
- Locust Grove Pediatrics's practice location on file with NPPES is 5040 Bill Gardner Pkwy, Locust Grove, GA 30248-3645.
- What is Locust Grove Pediatrics's phone number?
- The practice phone number listed in the NPPES registry for Locust Grove Pediatrics is (678) 583-5437.
- Who is the authorized official for Locust Grove Pediatrics?
- The authorized official listed on Locust Grove Pediatrics's NPPES record is John Mynatt, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Locust Grove Pediatrics's NPI active?
- Yes — Locust Grove Pediatrics's NPI (1174693519) is active in the NPPES registry as of the last update on 2007-09-10.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.