Organization Active NPI

Kids Start Pediatrics, P.C.

  • Pediatrics Physician
  • Lithia Springs, GA
National Provider Identifier
1093858037
Registry record updated Jan 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
38305 Issued in GA
Legal business name
KIDS START PEDIATRICS, P.C.
Practice address
1515 Westfork Drive
Suite C
Lithia Springs, GA 30122-1544
Phone
(770) 941-5552
Fax
(770) 941-2289
NPI assigned
Feb 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2012

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

Authorized official

Name
Yitzhak A. Melamed, M.D.NPI 1235123399
Title
Pediatricians
Phone
(770) 941-5552

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 38305 GA Primary

Addresses

Primary practice location

1515 Westfork Drive
Suite C
Lithia Springs, GA 30122-1544

Mailing address

1515 Westfork Drive
Suite C
Lithia Springs, GA 30122-1544
Phone (770) 941-5552

Other identifiers 1

IdentifierTypeStateIssuer
000618659DMedicaidGA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D0989048Kids Start Pediatrics, PC1515 Westfork Drive Suite E, Lithia Springs, GA 30122Certificate of waiverJul 15, 2027

National Provider Directory

National Provider Directory

Locations

1515 Westfork Dr
Ste C
Lithia Springs, GA 30122
Phone (770) 941-5552

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326412800000",
    "number": "1093858037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 WESTFORK DRIVE",
            "address_2": "SUITE C",
            "city": "LITHIA SPRINGS",
            "state": "GA",
            "postal_code": "301221544",
            "telephone_number": "770-941-5552",
            "fax_number": "770-941-2289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 WESTFORK DRIVE",
            "address_2": "SUITE C",
            "city": "LITHIA SPRINGS",
            "state": "GA",
            "postal_code": "301221544",
            "telephone_number": "770-941-5552",
            "fax_number": "770-941-2289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS START PEDIATRICS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2012-01-13",
        "status": "A",
        "authorized_official_last_name": "MELAMED",
        "authorized_official_first_name": "YITZHAK",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PEDIATRICIANS",
        "authorized_official_telephone_number": "770-941-5552",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "38305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000618659D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lithia Springs, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.