THE PEDIATRIC CENTER LLC (NPI# 1760602783) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760602783 |
| Entity Type | Organization |
| Organization Name | THE PEDIATRIC CENTER LLC |
| Practice Address |
509 Gordon Ave Thomasville GA 31792-6645 |
| Practice Telephone | 2292267544 |
| Practice Fax Number | 2292260314 |
| Mailing Telephone | 2292267544 |
| Mailing Fax Number | 2292260314 |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | TERESA CONE (RN,OFFICE MANAGER) |
| Authorized Official Telephone | 2292267544 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083696041 | The Pediatric Center LLC | Pediatrics | 5900 Waterloo Rd Ste 110, Columbia, MD 21045-2636 | 2005-11-16 |
| 1104047075 | The Pediatric Center LLC | Clinic/Center | 980 4th St Se, Cairo, GA 39828-3064 | 2007-05-01 |
| Street Address |
509 GORDON AVE |
| City | THOMASVILLE |
| State | GA |
| Zip Code | 31792-6645 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033186838 | Jose M Grave De Peralta | Pediatrics | 509 Gordon Ave, Thomasville, GA 31792-6645 | 2006-03-01 |
| 1245682103 | Nicole Simmons | Nurse Practitioner | 509 Gordon Ave, Thomasville, GA 31792-6645 | 2016-07-04 |
| 1790178564 | Martha Hanna | Nurse Practitioner | 509 Gordon Ave, Thomasville, GA 31792-6645 | 2015-03-18 |
| 1932430832 | Natalie Y Royal | Nurse Practitioner | 509 Gordon Ave, Thomasville, GA 31792-6645 | 2010-01-18 |
| 1265635254 | Salli Chism Lehman | Pediatrics | 509 Gordon Ave, Thomasville, GA 31792-6645 | 2007-06-07 |
| 1376511667 | Stacey W Johnson | Pediatrics | 509 Gordon Ave, Thomasville, GA 31792 | 2006-03-10 |
| 1023085420 | Timothy A Jones | Pediatrics | 509 Gordon Ave, Thomasville, GA 31792-6645 | 2006-03-03 |
| 1659348316 | Benjamin J Wilds | Pediatrics | 509 Gordon Ave, Thomasville, GA 31792-6645 | 2006-03-02 |
| 1629045398 | Holly M Crowley | Psychiatry & Neurology | 509 Gordon Ave, Thomasville, GA 31792-6645 | 2006-03-02 |
| 1235106048 | Amy A Cooper | Pediatrics | 509 Gordon Ave, Thomasville, GA 31792-6645 | 2006-03-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245739879 | Georgia Pines Community Service Board | Community/Behavioral Health | 407 Cloverdale Drive, Thomasville, GA 31792 | 2018-02-09 |
| 1932613551 | Diana Diaz | Physician Assistant | 2705 E Pinetree Blvd Ste A, Thomasville, GA 31792 | 2017-11-17 |
| 1194249425 | Bobbie Frazier | Contractor | 400 Cloverdale Dr, Thomasville, GA 31792 | 2017-07-28 |
| 1598132292 | Southern Scripts, LLC | Pharmacy | 501 Gordon Avenue, Thomasville, GA 31792 | 2015-08-28 |
| 1508248915 | Elizabeth Nicole Keen | Behavioral Analyst | 121 Covington Ave Apt 9, Thomasville, GA 31792 | 2015-06-22 |
| 1417341579 | Sheila L Stanley | Counselor | 301 Summercreek Cove, Thomasville, GA 31792 | 2015-03-26 |
| 1457749301 | Ashley Lamb | Speech-Language Pathologist | 1203 East Jackson Street, Thomasville, GA 31792 | 2014-12-30 |
| 1831403880 | Somnoquest | Durable Medical Equipment & Medical Supplies | 556 Hall Road, Thomasville, GA 31792 | 2010-08-02 |
| 1508000183 | Kashyap B Choksi | Internal Medicine | 100 Mimosa Drive 2nd Floor, Thomasville, GA 31792 | 2009-04-27 |
| 1205008786 | Mark J Glaccum | Chiropractor | 415 Gordon Avenue, Thomasville, GA 31792 | 2008-03-25 |
| Find all providers in zip 31792 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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|---|---|---|---|---|
| 1639359151 | Alexander Internal Medicine, Pa | Clinic/Center | 1300 Lexington Ave, Thomasville, NC 27360-3419 | 2007-11-13 |
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|---|---|---|---|---|
| 1942809108 | Lexington Primary Care LLC | Clinic/Center | 777 Athens Rd, Lexington, GA 30648-1902 | 2020-10-20 |
| 1619575834 | The Iv Spot, LLC. | Clinic/Center | 2100 Parklake Dr Ne # C-5, Atlanta, GA 30345-2824 | 2020-10-09 |
| 1528673514 | Safe Haven Medical Services | Clinic/Center | 444 Racetrack Rd, Mcdonough, GA 30252-6837 | 2020-09-15 |
| 1780296533 | North Atlanta Mental Wellness | Clinic/Center | 1742 Mount Vernon Rd Ste 150b, Atlanta, GA 30338-4251 | 2020-08-21 |
| 1639788136 | Walker Health and Wellness LLC | Clinic/Center | 111 Bradford Dr, Bloomingdale, GA 31302-4926 | 2020-07-30 |
| 1942827332 | Primary Care of Coastal Georgia | Clinic/Center | 214a Professional Cir, St Marys, GA 31558 | 2020-07-01 |
| 1598389637 | Mercie Health | Clinic/Center | 3721 New Macland Rd Ste 246, Powder Springs, GA 30127-2000 | 2020-06-04 |
| 1366061699 | Beyondmed LLC | Clinic/Center | 1820 Willow Branch Ln Nw, Kennesaw, GA 30152-4558 | 2020-04-16 |
| 1366082596 | Rock Health Inc | Clinic/Center | 5385 Five Forks Trickum Rd Ste F, Stone Mountain, GA 30087-3018 | 2020-01-15 |
| 1477192219 | Meridian Corporate Healthcare of Georgia P C | Clinic/Center | 5163 Thompson Bridge Rd, Murrayville, GA 30564-1930 | 2019-12-26 |
| Find all providers with the same taxonomy | ||||
| City | THOMASVILLE |
| Zip Code | 31792 |
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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.