CHILDRENS CLINIC LLC (NPI# 1538686613) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538686613 |
| Entity Type | Organization |
| Organization Name | CHILDRENS CLINIC LLC |
| Practice Address |
931 Lower Fayetteville Rd Ste J Newnan GA 30263-5790 |
| Practice Telephone | (770) 253-0170 |
| Practice Fax Number | 7702530206 |
| Mailing Telephone | 7702530170 |
| Mailing Fax Number | 7702530206 |
| Enumeration Date | 2017-08-29 |
| Last Update Date | 2017-08-29 |
| Authorized Official Name | PATTI FERGUSON (MANAGER) |
| Authorized Official Telephone | 7702530170 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689739971 | Childrens Clinic LLC | Pediatrics | 3 Storehouse Lane, Suite B, Destrehan, LA 70047 | 2006-12-27 |
| 1225193501 | Childrens Clinic LLC | Pediatrics | 5037 Veterans Blvd, Suite 2e, Metairie, LA 70006 | 2006-12-27 |
| Street Address |
931 LOWER FAYETTEVILLE RD STE J |
| City | NEWNAN |
| State | GA |
| Zip Code | 30263-5790 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659357382 | Malcolm Henry Cole Jr. | Specialist | 931 Lower Fayetteville Rd Ste J, Newnan, GA 30263-5790 | 2005-12-15 |
| 1134644743 | Shannon Leigh Boles | Pediatrics | 931 Lower Fayetteville Rd Ste J, Newnan, GA 30263-5790 | 2017-08-04 |
| 1588877393 | Vanessa Howell-philip | Nurse Practitioner | 931 Lower Fayetteville Rd Ste J, Newnan, GA 30263-5790 | 2007-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750914115 | Tina Harvey | Counselor | 55 A, Suite A, Newnan, GA 30263 | 2020-02-13 |
| 1407492846 | Pathways Center for Behavioral & Developmental Growth | Community/Behavioral Health | 78 Hospital Road, Newnan, GA 30263 | 2019-11-20 |
| 1831672047 | Jp & Jg Enterprises | Hospice Care, Community Based | 22 Madras Parkway, Newnan, GA 30263 | 2018-09-13 |
| 1376052928 | Newnan Endoscopy Center LLC | Clinic/Center | 1200 Lower Fayetteville Rd, Newnan, GA 30263 | 2017-09-27 |
| 1417314899 | Natalie Stephens | Speech-Language Pathologist | 87 Matador Way, Newnan, GA 30263 | 2016-01-15 |
| 1376943423 | Kathryn R Fletcher | Case Manager/Care Coordinator | 30 O'tara Woods Drive, Newnan, GA 30263 | 2014-08-26 |
| 1912260068 | Tamecia Hill | Counselor | 37 2nd Ave., Newnan, GA 30263 | 2012-06-22 |
| 1013289255 | Pathways Center for Behavioral and Developmental Growth | Community/Behavioral Health | 52 Perry St, Newnan, GA 30263 | 2012-02-03 |
| 1245513092 | Rocky Mountain Holdings LLC | Ambulance | 180 W Aviation Way, Newnan, GA 30263 | 2011-09-27 |
| 1316240427 | Georgia Cvs Pharmacy, LLC | Durable Medical Equipment & Medical Supplies | 395 Jackson St, Newnan, GA 30263 | 2010-12-10 |
| Find all providers in zip 30263 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| 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. |
| 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/certificatio - 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 |
|---|---|---|---|---|
| 1932373420 | Elizabeth Kinta Watkins | Pediatrics | 1111 Bullsboro Dr Ste 6-7, Newnan, GA 30265-2182 | 2008-04-16 |
| 1073560959 | Regina P Justice | Pediatrics | 2462 Highway 34 East, Suite A, Newnan, GA 30265 | 2006-05-27 |
| 1043265259 | Fred A Tega | Pediatrics | 15 Baynard Park, Newnan, GA 30265-6413 | 2006-05-24 |
| 1497714257 | Jill B Dickerson | Pediatrics | 10 Market Square Way Ste 100, Newnan, GA 30265-6078 | 2006-03-21 |
| 1891779096 | Lewis W. Jackson | Pediatrics | 2959 Sharpsburg Mccollum Rd, Newnan, GA 30265-2297 | 2005-12-01 |
| 1770566952 | J. Edwyn Carter | Pediatrics | 189 Jefferson Pkwy, Newnan, GA 30263-5823 | 2005-11-22 |
| 1134644743 | Shannon Leigh Boles | Pediatrics | 931 Lower Fayetteville Rd Ste J, Newnan, GA 30263-5790 | 2017-08-04 |
| 1568826253 | Michelle Payne | Pediatrics | 2959 Sharpsburg Mccullum Rd, Newnan, GA 30265-2297 | 2016-04-08 |
| 1740692813 | Olena Vanwonterghem | Pediatrics | 15 Baynard Park, Newnan, GA 30265-6413 | 2014-05-23 |
| 1992127856 | Pediatric Associates of Newnan P.C. | Pediatrics | 775 Poplar Rd, Suite 150, Newnan, GA 30265-8300 | 2014-01-13 |
| Find all providers in NEWNAN | ||||
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| 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.