Kids First Pediatric Group, LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

KIDS FIRST PEDIATRIC GROUP, LLC

Practice address

1045 Southcrest Dr
Suite 110
Stockbridge, GA 30281-6113

Phone

(770) 507-2212

Fax

(770) 507-2213

NPI assigned

Mar 5, 2007

Organization subpart

No

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

Authorized official

Name

Elaine C Youngblood, MDNPI 1831132646

Title

Physican Owner

Phone

(770) 506-2212

Specialties & licenses 1

Addresses

Locations

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Elaine C Youngblood, MD

  • Pediatrics Physician
  • Stockbridge, GA
  • NPI 1831132646

  Pediatrics

  NPD (past) Authorized official
• Sheila D Blake, RN, MNS,CPNP

  • Pediatric Nurse Practitioner
  • Stockbridge, GA
  • NPI 1457485682
  NPD (past)
• Nicola C Chin, MD

  • Pediatrics Physician
  • Atlanta, GA
  • NPI 1164465985

  Pediatrics

  NPD (past)
• Amanda J Raynor, CPNP

  • Pediatric Nurse Practitioner
  • Macon, GA
  • NPI 1043765720
  NPD (past)
• Wanda J Williams, MD

  • Pediatrics Physician
  • Stockbridge, GA
  • NPI 1932158383

  Pediatrics

  NPD (past)

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359504000000",
    "number": "1720117989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 SOUTHCREST DR",
            "address_2": "SUITE 110",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302816113",
            "telephone_number": "770-507-2212",
            "fax_number": "770-507-2213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 SOUTHCREST DR",
            "address_2": "SUITE 110",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302816113",
            "telephone_number": "770-507-2212",
            "fax_number": "770-507-2213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS FIRST PEDIATRIC GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2013-01-30",
        "status": "A",
        "authorized_official_last_name": "YOUNGBLOOD",
        "authorized_official_first_name": "ELAINE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PHYSICAN OWNER",
        "authorized_official_telephone_number": "770-506-2212",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sam A. Khair, M.D.
• Samuel Eric Khair, DO
• Fahad Khan, MD
• Ramsha Rehan Khan, PAC
• Navita Khatri, DPM
• Lindsey Kiesgen, AU.D.
• Alen Crystal Kim
• Diana Kim, D.O.
• Sora Kim
• Daphene Luvata Kimball-Butler, RN.PCM.CLC.SANE.

• All providers in Stockbridge, GA
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2013; 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.