Heart and Soul Pediatrics LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

HEART AND SOUL PEDIATRICS LLC

Doing business as

Heart and Soul Pediatrics

Practice address

205 Waleska Rd Ste 1C
Canton, GA 30114-2493

Phone

(470) 371-3271

Fax

(770) 345-0020

NPI assigned

Feb 7, 2020

Last updated

Mar 7, 2023By 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. Enid Colon, MDNPI 1306836747

Title

PCP

Phone

(770) 345-0055

Specialties & licenses 1

Addresses

Other names 1

• Heart and Soul Pediatrics Doing business as

Electronic endpoints 1

Practitioners 1

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.

• Enid Colon, MD

  • Pediatrics Physician
  • Canton, GA
  • NPI 1306836747
  NPD Authorized official

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

{
    "created_epoch": "1581033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1275165292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11770 HAYNES BRIDGE RD",
            "address_2": "SUITE 205 PMB 307",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300091968",
            "telephone_number": "470-371-3271",
            "fax_number": "770-345-0020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 WALESKA RD STE 1C",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301142493",
            "telephone_number": "470-371-3271",
            "fax_number": "770-345-0020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEART AND SOUL PEDIATRICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-07",
        "last_updated": "2023-03-07",
        "certification_date": "2020-04-09",
        "status": "A",
        "authorized_official_last_name": "COLON",
        "authorized_official_first_name": "ENID",
        "authorized_official_title_or_position": "PCP",
        "authorized_official_telephone_number": "770-345-0055",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ecolon@heartandsoulpediatrics.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "205 Waleska Rd Ste 1C",
            "city": "Canton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301142493",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Heart and Soul Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Heart and Soul Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pediatrics Physician in Canton, GA
• Providers in Canton, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.