Enid Colon, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

043020 Issued in GA

Practice address

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

Phone

(770) 345-0055

Fax

(770) 345-0020

NPI assigned

Oct 26, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ecolon4340@directwellstar.org

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.

• Heart and Soul Pediatrics LLC

  • Pediatrics Physician
  • Canton, GA
  • NPI 1275165292
  NPD Authorized official
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD
• Wellstar Health System, Inc.

  • Point of Service
  • Marietta, GA
  • NPI 1437219656

  Pediatrics

  NPD (past)
• Wellstar Kennestone Pediatric Associates, LLC

  • Pediatrics Physician
  • Marietta, GA
  • NPI 1083660682
  NPD (past)

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1306836747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11770 HAYNES BRIDGE RD STE 205",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300091968",
            "telephone_number": "770-345-0055",
            "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": "770-345-0055",
            "fax_number": "770-345-0020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLON",
        "first_name": "ENID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-26",
        "last_updated": "2023-03-07",
        "certification_date": "2020-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "043020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "43020",
            "state": "GA"
        }
    ],
    "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": []
}

• William Cole, MSN, APRN, FNP-BC
• Sarah Ann Collett
• Jacqueline Shea Collier, RN, IBCLC
• Sidney Boyd Collier III, PHARM D
• David Richard Collins, M.D.
• Brooke A Comley, LMSW
• Compassion Care Connections Corporation
• Comprehensive Therapy Consultants
• Cassidy Comrie
• Connect the Dots Coordination, Inc.

• 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.