Zoe Center for Pediatric & Adolescent Health, LLC

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

39388 Issued in GA

Legal business name

ZOE CENTER FOR PEDIATRIC & ADOLESCENT HEALTH, LLC

Practice address

210 Hannahs Mill Rd
Thomaston, GA 30286-2801

Phone

(706) 938-0990

NPI assigned

Feb 22, 2012

Last updated

Mar 30, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Stephanie Kong, MDNPI 1508851908

Title

Owner

Phone

(706) 938-0990

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Zoe Center for Pediatric3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Zoe Center for Pediatric & Adolescent Health, LLC

  • Pediatrics Physician
  • Barnesville, GA
  • NPI 1477815306
  NPD tax ID
• Zoe Center for Pediatric & Adolescent Health, LLC

  • Pediatrics Physician
  • Barnesville, GA
  • NPI 1861748535
  NPD tax ID

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/AJCHBA

Practitioners 51

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stephanie H Kong, M.D.

  • Pediatrics Physician
  • Thomaston, GA
  • NPI 1508851908
  Medicare reassignment NPD Authorized official
• Lindsey Nicole Burnett, M.D.

  • Pediatrics Physician
  • Barnesville, GA
  • NPI 1497199871

  Multi-Specialty

  Medicare reassignment NPD
• Charlaya D Campbell, MD

  • Pediatrics Physician
  • Barnesville, GA
  • NPI 1568636322
  Medicare reassignment NPD
• Jeremiah A D'Annunzio, PNP

  • Pediatrics Physician
  • Thomaston, GA
  • NPI 1437713112
  Medicare reassignment NPD
• Akram Elamaari, M.D.

  • Pediatrics Physician
  • Decatur, GA
  • NPI 1881981934
  Medicare reassignment NPD
• Christy Lynn Ott McKay, M.D.

  • Pediatrics Physician
  • Columbus, GA
  • NPI 1417268210
  Medicare reassignment NPD
• Denishia Karnell Tatum, CPNP-PC

  • Pediatric Nurse Practitioner
  • Columbus, GA
  • NPI 1760949473
  Medicare reassignment NPD
• Mustafa Bakir, MD

  • General Practice Physician
  • Ponte Vedra Beach, FL
  • NPI 1568988129

  GA, Single Specialty

  Medicare reassignment NPD
• Stella A. Debrah-Siriboe, M.D.

  • Pediatrics Physician
  • Culpeper, VA
  • NPI 1225027618

  GA

  Medicare reassignment NPD
• Linda Ruth Gordon, MD

  • Pediatrics Physician
  • Anniston, AL
  • NPI 1447282637

  GA

  Medicare reassignment NPD
• Erica Denise Ferrell, CFNP

  • Family Nurse Practitioner
  • Barnesville, GA
  • NPI 1881229045
  NPD
• Ashleigh Massey, RBT

  • Behavior Technician
  • Columbus, GA
  • NPI 1265145973
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1329868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585526400000",
    "number": "1053684936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "959 17TH ST STE B",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319011984",
            "telephone_number": "706-507-9127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 HANNAHS MILL RD",
            "city": "THOMASTON",
            "state": "GA",
            "postal_code": "302862801",
            "telephone_number": "706-938-0990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZOE CENTER FOR PEDIATRIC & ADOLESCENT HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-22",
        "last_updated": "2020-03-30",
        "certification_date": "2020-03-30",
        "status": "A",
        "authorized_official_last_name": "KONG",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-938-0990",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "GA",
            "license": "39388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003122332A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ZOEPEDS",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "210 Hannahs Mill Rd",
            "city": "Thomaston",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302862801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Andrea Carter Wolverton, LMFT, CADC II
• Amber Jones Womack, NP
• Shameika Worthy, LPC
• Rhanada Shanae Wyche, LPN
• Candice Young, NP-C

• Pediatric Adolescent Medicine Physician in Thomaston, GA
• Providers in Thomaston, GA by specialty
• Pediatric Adolescent Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.