Kidcare Pediatrics

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

KIDCARE PEDIATRICS

Practice address

2565 Jolly Rd Ste a
College Park, GA 30349-3103

Phone

(404) 765-9437

Fax

(404) 669-9347

NPI assigned

Oct 5, 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

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

CLIA laboratory certificates

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
  • Atlanta, GA
  • NPI 1417044181
  NPD tax ID

Locations

Practitioners 5

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

• Jessica Hope Livsey, MD

  • Pediatrics Physician
  • Atlanta, GA
  • NPI 1245727130
  NPD
• Brittany Renee Cole, MD

  • Pediatrics Physician
  • Lakeport, CA
  • NPI 1649634361
  NPD
• Maria G. Axelrod, MD

  • Pediatrics Physician
  • Atlanta, GA
  • NPI 1558368845
  NPD (past)
• Helena K Bentley, M.D.

  • Pediatrics Physician
  • College Park, GA
  • NPI 1881632644
  NPD (past)
• Jamika Warren Trawick, M.D.

  • Pediatrics Physician
  • College Park, GA
  • NPI 1477578375
  NPD (past)

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600214400000",
    "number": "1871689265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2565 JOLLY RD STE A",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303493103",
            "telephone_number": "404-765-9437",
            "fax_number": "404-669-9347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2565 JOLLY RD STE A",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303493103",
            "telephone_number": "404-765-9437",
            "fax_number": "404-669-9347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDCARE PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "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": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "GA",
            "license": "027494",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000359675G",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kay's Karing Hands, LLC
• Valencia Kelly
• Kenoly Emerging Technologies, LLC
• Kimberly Kerbo
• Tomeka Khaaliq, LPN
• Kids Avenue Pediatrics LLC
• Kids Avenue Pediatrics LLC
• Travis E Kimble, DDS
• Malika King
• Denniesha Andrene Knight

• Pediatrics Physician in College Park, GA
• Providers in College Park, 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.
• 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.