NPIMap

Organization Active NPI

Kids First Pediatrics of Georgia, P.C.

  • Pediatrics Physician
  • Pooler, GA
National Provider Identifier
1326269598
Registry record updated Jul 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
KIDS FIRST PEDIATRICS OF GEORGIA, P.C.
Practice address
143 Canal St
Suite 200
Pooler, GA 31322-6007
Phone
(912) 748-4527
Fax
(912) 748-9016
NPI assigned
May 2, 2007
Last updated
Jul 23, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2012

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

Authorized official

Name
Dr. Karen Michelle Kim, M.D.NPI 1144213018
Title
Ceo
Phone
(912) 748-4527

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 Physician 208000000X NU Primary

Addresses

Primary practice location

143 Canal St
Suite 200
Pooler, GA 31322-6007

Mailing address

PO Box 668
Pooler, GA 31322-0668
Phone (912) 748-4527

Other identifiers 22

IdentifierTypeStateIssuer
000725381BMedicaidGA
000835535BMedicaidGA
000839682BMedicaidGA
1033307293OtherGAPEDIATRICS-DR KARA L. KENNEDY
837258124CMedicaidGA
897572509AMedicaidGA
920085272AMedicaidGA
000835535CMedicaidGA
837258124BMedicaidGA
920085272CMedicaidGA
000835535DMedicaidGA
000725381CMedicaidGA
1831188259OtherGAPEDIATRICS-DR YOLANDA M. RIVERA-CAUDILL
000839682DMedicaidGA
1144213018OtherGAPEDIATRICS-DR KAREN M. KIM
1326048992OtherGAPEDIATRICS-DR FRANCISCO J. HERRAN
1811980741OtherGAPEDIATRICS-DR ROLANDO Z. MANALO
920085272BMedicaidGA
1134193642OtherGAPEDIATRICS-DR RONALD G.JONES
837258124AMedicaidGA
897572509BMedicaidGA
897572509CMedicaidGA

Other names 1

  • Pooler Pediatrics, P.C. Former legal business name

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
11D0987757Kids First Pediatrics of Georgia PC143 Canal Street, Suite 500, Pooler, GA 31322ComplianceAug 7, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343001600000",
    "number": "1326269598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 668",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313220668",
            "telephone_number": "912-748-4527",
            "fax_number": "912-748-9016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 CANAL ST",
            "address_2": "SUITE 200",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313226007",
            "telephone_number": "912-748-4527",
            "fax_number": "912-748-9016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS FIRST PEDIATRICS OF GEORGIA, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-02",
        "last_updated": "2012-07-23",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "912-748-4527",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000725381B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000835535B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000839682B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEDIATRICS-DR KARA L. KENNEDY",
            "identifier": "1033307293",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "837258124C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "897572509A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "920085272A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000835535C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "837258124B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "920085272C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000835535D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000725381C",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEDIATRICS-DR YOLANDA M. RIVERA-CAUDILL",
            "identifier": "1831188259",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000839682D",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEDIATRICS-DR KAREN M. KIM",
            "identifier": "1144213018",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEDIATRICS-DR FRANCISCO J. HERRAN",
            "identifier": "1326048992",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEDIATRICS-DR ROLANDO Z. MANALO",
            "identifier": "1811980741",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "920085272B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEDIATRICS-DR RONALD G.JONES",
            "identifier": "1134193642",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "837258124A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "897572509B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "897572509C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pooler Pediatrics, P.C.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Pooler, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.