THE CHILDREN'S & ADOLESCENT MEDICAL CENTER PC (NPI# 1225096837) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225096837 |
| Entity Type | Organization |
| Organization Name | THE CHILDREN'S & ADOLESCENT MEDICAL CENTER PC |
| Practice Address |
4905 Courtney Dr Forest Park GA 30297-1427 |
| Practice Telephone | 4043663636 |
| Practice Fax Number | 4043620808 |
| Mailing Telephone | 4043663636 |
| Mailing Fax Number | 4043620808 |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. MARION M MCCELLAN JR. (OWNER) |
| Authorized Official Telephone | 4043663636 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
008497 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
4905 COURTNEY DR |
| City | FOREST PARK |
| State | GA |
| Zip Code | 30297-1427 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477537322 | Abigail Kamishlian | Pediatrics | 4905 Courtney Dr, Forest Park, GA 30297-1427 | 2005-12-05 |
| 1871969469 | Lisa Roseberry | Nurse Practitioner | 4905 Courtney Dr, Forest Park, GA 30297-1427 | 2015-08-18 |
| 1174916621 | Antoinette Denise Palomino | Nurse Practitioner | 4905 Courtney Dr, Forest Park, GA 30297-1427 | 2015-03-09 |
| 1386051712 | Fahimot Oyinlola Faduyile | Pediatrics | 4905 Courtney Dr, Forest Park, GA 30297-1427 | 2014-07-17 |
| 1861827891 | Nancy Elizabeth Clines | Pediatrics | 4905 Courtney Dr, Forest Park, GA 30297-1427 | 2013-09-10 |
| 1437449964 | Daliannys Morales Mendez | Pediatrics | 4905 Courtney Dr, Forest Park, GA 30297-1427 | 2011-04-18 |
| 1588983514 | Crystal Mercia Malvoisin | Pediatrics | 4905 Courtney Dr, Forest Park, GA 30297-1427 | 2010-06-01 |
| 1780821884 | Shonte Henderson | Pediatrics | 4905 Courtney Dr, Forest Park, GA 30297-1427 | 2009-01-12 |
| 1033383799 | Salma Elmubarak Elkhabier | Pediatrics | 4905 Courtney Dr, Forest Park, GA 30297-1427 | 2008-04-14 |
| 1396880837 | Taisha K Okafor | Pediatrics | 4905 Courtney Dr, Forest Park, GA 30297-1427 | 2007-02-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548747173 | Ga Peach Medical Transportation, LLC | Ambulance | 5023 Highway 85, Forest Park, GA 30297 | 2018-07-26 |
| 1871940437 | Crystal Harrison | Counselor | 4659 Ruby Ln, Forest Park, GA 30297 | 2016-05-24 |
| 1467807156 | Naundria Jackson | Nurse Practitioner | Apmc, Forest Park, GA 30297 | 2016-04-29 |
| 1891156089 | Gentle Care Medical Trans LLC | Ambulance | 530 Forest Parkway Suite B, Forest Park, GA 30297 | 2016-03-15 |
| 1811318835 | Kim Mckinney | Case Manager/Care Coordinator | 1104 South Parkwood Drive, Forest Park, GA 30297 | 2013-12-17 |
| 1215361910 | Tiffany Nadine Adams | Specialist | 228 Morrow Rd 18h, Forest Park, GA 30297 | 2013-08-29 |
| 1851663124 | Daffodil Pediatrics and Family Medicine | Pediatrics | 4905 Courtney Drive, Forest Park, GA 30297 | 2012-02-02 |
| 1093093759 | Truliant Health Systems | Community/Behavioral Health | 526 Forest Parkway Ste D, Forest Park, GA 30297 | 2011-07-29 |
| 1811134133 | Sharonda Renee Forte | Orthopaedic Surgery | 4940 Governors Park Drive, Forest Park, GA 30297 | 2009-01-08 |
| 1215173737 | Comfort Personal Care Service | Assisted Living Facility | 5530 Old Dixie Highway, D-9, Forest Park, GA 30297 | 2009-01-06 |
| Find all providers in zip 30297 | ||||
| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265491138 | Marion M Mcclellan Jr. | Pediatrics | 4905 Courtney Dr, Forest Park, GA 30297-1427 | 2006-03-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427616515 | Pedsnow LLC | Pediatrics | 863 W Oglethorpe Hwy Ste 220, Hinesville, GA 31313-4491 | 2019-06-03 |
| 1073885828 | Middle Georgia Pediatrics | Pediatrics | 1508 Hardeman Ave Ste B, Macon, GA 31201-1471 | 2012-02-08 |
| 1003184409 | Greer Gadsden Larned, M.d., P.C., Faap | Pediatrics | 3802 Waters Ave, Savannah, GA 31404-6210 | 2011-12-13 |
| 1427333095 | Dahlonega Pediatric and Adolescent Medicine | Pediatrics | 1055 North Grove St., Dahlonega, GA 30533 | 2011-10-14 |
| 1770710824 | Children's Medicine of Rockdale | Pediatrics | 1765 Parker Rd Se, Suite B210, Conyers, GA 30094-6652 | 2009-06-16 |
| 1518110451 | Pedia Doc Children's Med Ctr | Pediatrics | 3088 Campbellton Rd Sw, Atlanta, GA 30311-5410 | 2008-10-23 |
| 1396929444 | Total Grace Pediatrics P.C. | Pediatrics | 900 N Hairston Rd # Rs, Suite A, Stone Mountain, GA 30083-2857 | 2007-12-26 |
| 1306060801 | Crystal M Edds | Pediatrics | 125b Victory Dr, Swainsboro, GA 30401-3234 | 2007-04-13 |
| 1962523639 | William P Bristol | Pediatrics | 3300 Fourth Street, Brunswick, GA 31520-3779 | 2007-04-02 |
| 1861527103 | Florida Selga Basilio | Pediatrics | 1519 13th Ave, Columbus, GA 31901-1908 | 2007-02-23 |
| Find all providers with the same taxonomy | ||||
| City | FOREST PARK |
| Zip Code | 30297 |
Please comment or provide details below to improve the information on THE CHILDREN'S & ADOLESCENT MEDICAL CENTER PC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.