Raven Childs

Primary specialty

Clinical Laboratory Director (Non-physician)Taxonomy code 247ZC0005X

License

11D2327258 Issued in GA

Practice address

260 Peachtree St NW Ste 2200
Atlanta, GA 30303-1292

Phone

(404) 429-8377

NPI assigned

Aug 8, 2025

Last updated

Aug 8, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jyc Testing & Diagnostics

  • Clinical Medical Laboratory
  • Atlanta, GA
  • NPI 1548145493
  NPD Authorized official

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

{
    "created_epoch": "1754611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754611200000",
    "number": "1356226203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 OAK KNOLL TER SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303155214",
            "telephone_number": "404-429-8377",
            "fax_number": "404-429-8377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 PEACHTREE ST NW STE 2200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303031292",
            "telephone_number": "404-429-8377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDS",
        "first_name": "RAVEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-08",
        "last_updated": "2025-08-08",
        "certification_date": "2025-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247ZC0005X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Clinical Laboratory Director, Non-physician",
            "state": "GA",
            "license": "11D2327258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kiante Karin Childress
• Krista Jo Childress, MD
• Carlito Demoz Childs
• Martha Childs, PHARMACY.D.
• Megan Jasmine Childs, CAA
• Jennifer Ottenweller Chiles
• Sierra Simone Troupe Chilian, COTA/L
• Camille Chiller
• Ishan Ravi Chillikatil
• Jennifer S Chimento, FNP-C

• Clinical Laboratory Director (Non-physician) in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Clinical Laboratory Director (Non-physician) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2025; 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.