DR. PATRICE GIBSON CHISHOM MD
NPI 1366441032
Pediatrics in Clarkston, GA

Q: What is Patrice Chishom's NPI number?

The NPI number for Patrice Chishom is 1366441032. It was assigned to this individual provider in the NPPES registry on July 15, 2005. The provider is also known as Patrice Dannette Gibson.

Q: What is Patrice Chishom's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Patrice Chishom was last updated on March 20, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 15, 2005

4112 E PONCE DE LEON AVE, CLARKSTON, GA 30021(404) 289-7133(404) 289-7211 Get Directions Write a Review

NPPES record last updated: March 20, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dr. Patrice Gibson Chishom Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. PATRICE GIBSON CHISHOM MD (NPI 1366441032) is an individual pediatrics provider in Clarkston, Georgia, licensed in Georgia (045185) and active in the NPI registry since July 2005.

NPPES Registry Identity

NPI1366441032

Entity TypeIndividualFemale

Primary Taxonomy208000000X

Provider Legal NameDR. PATRICE GIBSON CHISHOMCredential: MD

Location Address4112 E PONCE DE LEON AVEClarkston, GA 30021-8106

Mailing Address4112 E Ponce De Leon AveClarkston, GA 30021-8106 · (404) 289-7133 · Fax (404) 289-7211

Phone(404) 289-7133

Fax(404) 289-7211

Sole ProprietorNo

Enumeration DateJuly 15, 2005

Last NPPES UpdateMarch 20, 2022

NPPES CertifiedMarch 20, 2022

✔ NPI 1366441032 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in GA · 045185

Definition

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.

4112 E PONCE DE LEON AVE, Clarkston, GA 30021

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Other Names 1

Former Name (1)Patrice Dannette Gibson

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EMILY HOWELL CURIA NP

Nurse Practitioner (Pediatrics)