CAMP CREEK PEDIATRICS LLC (NPI# 1922269612) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922269612 |
| Entity Type | Organization |
| Organization Name | CAMP CREEK PEDIATRICS LLC |
| Practice Address |
3890 Redwine Rd Sw Suite 100 Atlanta GA 30331-5582 |
| Mailing Address |
1415 Highway 85 N Suite 310-246 Fayetteville GA 30214-4035 |
| Practice Telephone | 4043492273 |
| Mailing Telephone | 4043492273 |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2008-06-24 |
| Authorized Official Name | DR. CHARLENE JOHNSON-BROWN (PHYSICIAN) |
| Authorized Official Telephone | 4043492273 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
049655 | GA | Ambulatory Health Care Facilities |
| Street Address |
3890 REDWINE RD SW SUITE 100 |
| City | ATLANTA |
| State | GA |
| Zip Code | 30331-5582 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588659908 | Dara Paul | Specialist | 3890 Redwine Rd Sw, Ste 210, Atlanta, GA 30331-5509 | 2005-09-12 |
| 1538616305 | Marion Bianca Tyson | Physical Therapist | 3890 Redwine Rd Sw, Suite 114, Atlanta, GA 30331-5582 | 2016-09-08 |
| 1871853606 | Paddyson Chukwuka Chidi | Physical Therapist | 3890 Redwine Rd Sw, Suite 114, Atlanta, GA 30331-5582 | 2012-05-27 |
| 1447529342 | Pain Management of The South | Anesthesiology | 3890 Redwine Rd Sw, Suite 200, Atlanta, GA 30331-5582 | 2011-12-21 |
| 1487957924 | Pinnacle Diagnostic and Dme Services, LLC | Durable Medical Equipment & Medical Supplies | 3890 Redwine Rd Sw, Suite 200, Atlanta, GA 30331-5582 | 2010-12-06 |
| 1598072910 | Willis C Jenkins | Physical Therapy Assistant | 3890 Redwine Rd Sw, Suite 114, Atlanta, GA 30331-5582 | 2010-09-07 |
| 1184939456 | Accident Centers of Atlanta, LLC | Durable Medical Equipment & Medical Supplies | 3890 Redwine Rd Sw, Suite 200, Atlanta, GA 30331-5582 | 2010-08-11 |
| 1770811713 | Camp Creek Smiles Family Dentistry | Clinic/Center | 3890 Redwine Rd Sw, Ste 108, Atlanta, GA 30331-5582 | 2009-12-03 |
| 1700072485 | Premier Eye Physicians PC | Clinic/Center | 3890 Redwine Rd Sw, Suite 212, Atlanta, GA 30331-5582 | 2007-09-17 |
| 1861600520 | Genesis Sports Medicine and Rehabilitation, LLC | Clinic/Center | 3890 Redwine Rd Sw, Atlanta, GA 30331-5582 | 2007-05-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861001174 | Whitney Flemister | Social Worker | 3961 Princeton Lakes Way Sw, Atlanta, GA 30331 | 2020-07-23 |
| 1982237400 | Publix Super Markets, Inc. | Durable Medical Equipment & Medical Supplies | 5829 Campbellton Road, S.w, Suite 110, Atlanta, GA 30331 | 2020-02-13 |
| 1295375558 | Drusilla Precious Cudjoe | Behavior Technician | 3800 Camp Creek Parkway Sw, Building 1400, Atlanta, GA 30331 | 2020-01-14 |
| 1497262778 | Champions Pharmacy | Pharmacy | 3886 Princeton Lakes Way Suite 180, Atlanta, GA 30331 | 2018-01-08 |
| 1033629779 | Carmen Ardoin | Counselor | 2636 Martin Luther King Jr. Drive, Suite 12, Atlanta, GA 30331 | 2017-10-09 |
| 1346759974 | Neva R Allison | Nurse Practitioner | 2611 Dayview Ln, Atlanta, GA 30331 | 2017-09-26 |
| 1538678255 | Natalie Mckay | Technician/Technologist | 3915 Cascade Rd, 220, Atlanta, GA 30331 | 2017-09-26 |
| 1700304268 | Tyrone Pipkin | Contractor | 415 Kendrick Terrace Sw, Atlanta, GA 30331 | 2017-09-05 |
| 1073031688 | Kristen Wooldridge | Pharmacist | 3695 Cascade Road, Atlanta, GA 30331 | 2017-09-04 |
| 1548704687 | Advance Pain Management | Health Maintenance Organization | 2950 Stone Hogan Road Connector, Atlanta, GA 30331 | 2016-12-08 |
| Find all providers in zip 30331 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780947978 | Independent Physical Therapy of Georgia, LLC | Clinic/Center | 2255 Peachtree Rd Ne, Ste G, Atlanta, GA 30309-1101 | 2012-06-21 |
| 1467719849 | Mina Jacob, Md, PC | Clinic/Center | 1300 Peachtree Battle Ave Nw, Atlanta, GA 30327-1424 | 2012-04-23 |
| 1558525071 | Charlene Johnson Md LLC | Clinic/Center | 2945 Stone Hogan Rd, Suite 201, Atlanta, GA 30331-2835 | 2008-07-14 |
| 1497954093 | Orthopaedic & Spine Surgery of Atlanta | Clinic/Center | 3161 Howell Mill Road, Suite 400, Atlanta, GA 30327 | 2007-07-13 |
| 1336345982 | Emory Healthcare | Clinic/Center | The Emory Clinic 1525 Clifton Rd, Atlanta, GA 30322-0001 | 2007-06-21 |
| 1568822195 | H & Z Acupuncture LLC | Clinic/Center | 57 Executive Park S, Atlanta, GA 30329-2288 | 2016-02-24 |
| 1780043547 | H & Z Acupuncture LLC | Clinic/Center | 57 Executive Park S, 150, Atlanta, GA 30329-2288 | 2016-02-22 |
| 1467825281 | J Dewayne Colquitt Md LLC | Clinic/Center | 35 Collier Rd Nw Ste 675, Atlanta, GA 30309-1612 | 2015-11-02 |
| 1972929685 | Withinme Md, Atlanta | Clinic/Center | 604 Glen Iris Dr Ne, Atlanta, GA 30308-2717 | 2014-03-06 |
| 1003247859 | Legacy Women's Healthcare, PC | Clinic/Center | 960 Johnson Fy Rd Ne, Suite 215, Atlanta, GA 30342-1631 | 2013-12-04 |
| Find all providers in ATLANTA | ||||
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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.