Kidcare Pediatrics

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

KIDCARE PEDIATRICS

Practice address

910 Dannon VW SW Ste 2101
Atlanta, GA 30331-2156

Phone

(404) 691-6100

Fax

(404) 691-6959

NPI assigned

Oct 6, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Chauncey Daniels

Title

Ceo

Phone

(404) 765-9437

Specialties & licenses 2

Addresses

Other identifiers 1

Tax ID family

Kidcare Pediatrics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Kidcare Pediatrics

  • Pediatrics Physician
  • College Park, GA
  • NPI 1871689265
  NPD tax ID

Locations

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600214400000",
    "number": "1417044181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 DANNON VW SW STE 2101",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303312156",
            "telephone_number": "404-691-6100",
            "fax_number": "404-691-6959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 DANNON VW SW STE 2101",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303312156",
            "telephone_number": "404-691-6100",
            "fax_number": "404-691-6959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDCARE PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A",
        "authorized_official_last_name": "DANIELS",
        "authorized_official_first_name": "CHAUNCEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "404-765-9437",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "GA",
            "license": "057447",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000359675H",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kiaan Shah Investments LLC
• Negar Kianian, DMD
• Gregory Kibler, PA-C
• Lisa Kiblinger
• Lindsay Susanne Kibuyaga, MD
• Casandra M Kidd, DRPH
• Charlene Byssainthe Kidd, LCSW
• Jordan Kidd, CPHT
• Shane Kidd
• Kidgroups, LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; 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.