Kids Time Pediatrics, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

KIDS TIME PEDIATRICS, LLC

Practice address

696 Billups Ave
Madison, GA 30650-1439

Phone

(706) 342-2180

NPI assigned

Jun 22, 2007

Last updated

Jun 18, 2008By 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

Flynn Clyburn

Title

President

Phone

(706) 342-2180

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1182470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1164628681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "696 BILLUPS AVE",
            "city": "MADISON",
            "state": "GA",
            "postal_code": "306501439",
            "telephone_number": "706-342-2180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "696 BILLUPS AVE",
            "city": "MADISON",
            "state": "GA",
            "postal_code": "306501439",
            "telephone_number": "706-342-2180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS TIME PEDIATRICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-22",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "CLYBURN",
        "authorized_official_first_name": "FLYNN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "706-342-2180"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniela Juarez, PTA
• Pamela Clardy Key
• Kids Time Pediatrics - Alpharetta, LLC
• Kids Time Pediatrics - East Cobb LLC (Kids Time Pediatrics)
• Kids Time Pediatrics - East Cobb, LLC
• Caitlin Elizabeth Krieger, PA-C
• Lakeview Manor, LLC
• Haley Masland Lapaquette, PHARMD
• George Bazant Launius, RPH
• John W Layher Jr., MD

• Clinical Medical Laboratory in Madison, GA
• Providers in Madison, GA by specialty
• Clinical Medical Laboratory in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; 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.