Pediatric Medicine of Cartersville, P.C.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN120899 Issued in GA

Legal business name

PEDIATRIC MEDICINE OF CARTERSVILLE, P.C.

Practice address

20 Collins Dr
Suite B
Cartersville, GA 30120-2486

Phone

(770) 607-0795

Fax

(770) 607-1339

NPI assigned

Jan 18, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Thomas D Ryan, M.D.

Title

Ceo

Phone

(770) 607-0795

Specialties & licenses 3

Addresses

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

CLIA laboratory certificates

Locations

Practitioners 3

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

• Gina P Clevenger, C-FNP

  • Family Nurse Practitioner
  • Rome, GA
  • NPI 1861599045
  NPD (past)
• Jeannette Chua Cocabo, MD

  • Pediatrics Physician
  • Cartersville, GA
  • NPI 1508343021
  NPD (past)
• Kirsten Nations Johnson, CPNP

  • Pediatric Nurse Practitioner
  • Cartersville, GA
  • NPI 1972564102

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1851444632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 COLLINS DR",
            "address_2": "SUITE B",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301202486",
            "telephone_number": "770-607-0795",
            "fax_number": "770-607-1339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 COLLINS DR",
            "address_2": "SUITE B",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301202486",
            "telephone_number": "770-607-0795",
            "fax_number": "770-607-1339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC MEDICINE OF CARTERSVILLE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-607-0795",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "042415",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN120899",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "RN089950",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tammy Patterson
• Mark Alfred William Paun, M.D.
• Kristina Sarber Payne, MA, LPC, NCC
• William R Payne, MD
• Jennifer Payton, RD
• Pediatric Services of America, LLC
• Jason Pelaez
• Courtney Perez, M.D.
• Katy Perkins, MS
• Daniel G Pernell, PT

• Family Nurse Practitioner in Cartersville, GA
• Providers in Cartersville, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.