Individual provider Active NPI

Cedric Bernard Windom II, MD

  • Pediatrics Physician
  • Dalton, GA
National Provider Identifier
1063145357
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2022024908 Issued in MO
Practice address
2918 E Walnut Ave
Dalton, GA 30721-8724
Phone
(706) 529-4600
Fax
(706) 529-4633
NPI assigned
Jul 5, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2022024908 MO Primary

Addresses

Primary practice location

2918 E Walnut Ave
Dalton, GA 30721-8724

Mailing address

2918 E Walnut Ave
Dalton, GA 30721-8724
Phone (706) 529-4600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Bright Pediatrics, PC Pediatrics CurrentSince Sep 14, 2025 Accepting new patients

Locations

2918 E Walnut Ave
Dalton, GA 30721
Phone (706) 529-4600

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1656979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1063145357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2918 E WALNUT AVE",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307218724",
            "telephone_number": "706-529-4600",
            "fax_number": "706-529-4633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2918 E WALNUT AVE",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307218724",
            "telephone_number": "706-529-4600",
            "fax_number": "706-529-4633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINDOM",
        "first_name": "CEDRIC",
        "middle_name": "BERNARD",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-05",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2022024908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.