KIDS TIME PEDIATRICS - EAST COBB LLC (NPI# 1184935223) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184935223 |
| Entity Type | Organization |
| Organization Name | KIDS TIME PEDIATRICS - EAST COBB LLC |
| Other Organization Name | KIDS TIME PEDIATRICS |
| Practice Address |
696 Billups Ave Madison GA 30650-1439 |
| Mailing Address |
3535 Roswell Rd Suite 54 Marietta GA 30062-8826 |
| Practice Telephone | 7063422180 |
| Mailing Telephone | 4049431979 |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2010-06-23 |
| Authorized Official Name | FLYNN CLYBURN (MANAGER) |
| Authorized Official Telephone | 7063422180 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
32201 | GA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Kids Time Pediatrics | Doing Business As Name - Organization |
| Street Address |
696 BILLUPS AVE |
| City | MADISON |
| State | GA |
| Zip Code | 30650-1439 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164628681 | Kids Time Pediatrics, LLC | Clinical Medical Laboratory | 696 Billups Ave, Madison, GA 30650-1439 | 2007-06-22 |
| 1518278324 | Kids Time Pediatrics - East Cobb, LLC | Pediatrics | 696 Billups Ave, Madison, GA 30650-1439 | 2010-06-25 |
| 1205157054 | Kids Time Pediatrics - Alpharetta, LLC | Pediatrics | 696 Billups Ave, Madison, GA 30650-1439 | 2010-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487219192 | Morgan County, Georgia Hospital Authority | Pharmacy | 1740 Lions Club Road, Madison, GA 30650 | 2019-05-08 |
| 1215420690 | Advantage Behavioral Health Systems | Clinic/Center | 1801 Prospect Rd., Madison, GA 30650 | 2018-06-11 |
| 1942791470 | Kristin Barnett | Social Worker | 256 W Washingtonst, Madison, GA 30650 | 2018-05-21 |
| 1710474275 | M S Publishing and Consulting LLC | Counselor | 256 W. Washiington Street, Madison, GA 30650 | 2018-04-19 |
| 1558818013 | Whitney Rena Walker | Technician | 778 Cooks Hill Rd, Madison, GA 30650 | 2016-09-01 |
| 1023366739 | Xcalibur | Durable Medical Equipment & Medical Supplies | 1071 Hanover Dr, Madison, GA 30650 | 2012-08-28 |
| 1629392170 | Tammy W Rustin | Pharmacist | 1441 Eatonton Rd, Ingles Pharmacy #444, Madison, GA 30650 | 2010-03-25 |
| 1861534463 | John Frederick Mcnees II | Optometrist | 173 So Main St, Madison, GA 30650 | 2007-02-12 |
| 1780746750 | Jacqueline Lamar Gruszynski | Speech-Language Pathologist | 1760 Westminister Way, Madison, GA 30650 | 2006-12-15 |
| 1003917535 | Marilyn S Snow | Counselor | 256 W Washington St, Madison, GA 30650 | 2006-09-26 |
| Find all providers in zip 30650 | ||||
| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467432252 | Bruce G Freeman | Pediatrics | 1110 Durham Rd, Madison, CT 06443-1858 | 2006-01-18 |
| 1518278324 | Kids Time Pediatrics - East Cobb, LLC | Pediatrics | 696 Billups Ave, Madison, GA 30650-1439 | 2010-06-25 |
| 1205157054 | Kids Time Pediatrics - Alpharetta, LLC | Pediatrics | 696 Billups Ave, Madison, GA 30650-1439 | 2010-06-16 |
| 1376769794 | Paula J. Cody | Pediatrics | 2880 University Ave, Madison, WI 53705-3644 | 2007-04-17 |
| 1750402038 | Connecticut Pediatric Otolaryngology | Pediatrics | 230 Boston Post Rd, Madison, CT 06443-2225 | 2007-04-03 |
| 1538126941 | Shoreline Pediatrics & Adolescent Medicine, P.C. | Pediatrics | 1110 Durham Rd, Madison, CT 06443-1858 | 2006-04-28 |
| 1457331191 | Karen Y Goldberg | Pediatrics | 1110 Durham Rd, Madison, CT 06443-1858 | 2006-01-19 |
| 1366422024 | Erin S. Springhorn | Pediatrics | 1110 Durham Rd, Madison, CT 06443-1858 | 2006-01-19 |
| 1740260348 | Edward H. Gleich | Pediatrics | 1110 Durham Rd, Madison, CT 06443-1858 | 2006-01-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427616515 | Pedsnow LLC | Pediatrics | 863 W Oglethorpe Hwy Ste 220, Hinesville, GA 31313-4491 | 2019-06-03 |
| 1073885828 | Middle Georgia Pediatrics | Pediatrics | 1508 Hardeman Ave Ste B, Macon, GA 31201-1471 | 2012-02-08 |
| 1003184409 | Greer Gadsden Larned, M.d., P.C., Faap | Pediatrics | 3802 Waters Ave, Savannah, GA 31404-6210 | 2011-12-13 |
| 1427333095 | Dahlonega Pediatric and Adolescent Medicine | Pediatrics | 1055 North Grove St., Dahlonega, GA 30533 | 2011-10-14 |
| 1770710824 | Children's Medicine of Rockdale | Pediatrics | 1765 Parker Rd Se, Suite B210, Conyers, GA 30094-6652 | 2009-06-16 |
| 1518110451 | Pedia Doc Children's Med Ctr | Pediatrics | 3088 Campbellton Rd Sw, Atlanta, GA 30311-5410 | 2008-10-23 |
| 1396929444 | Total Grace Pediatrics P.C. | Pediatrics | 900 N Hairston Rd # Rs, Suite A, Stone Mountain, GA 30083-2857 | 2007-12-26 |
| 1306060801 | Crystal M Edds | Pediatrics | 125b Victory Dr, Swainsboro, GA 30401-3234 | 2007-04-13 |
| 1962523639 | William P Bristol | Pediatrics | 3300 Fourth Street, Brunswick, GA 31520-3779 | 2007-04-02 |
| 1861527103 | Florida Selga Basilio | Pediatrics | 1519 13th Ave, Columbus, GA 31901-1908 | 2007-02-23 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.