KENNESAW PEDIATRICS (NPI# 1659565562) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659565562 |
| Entity Type | Organization |
| Organization Name | KENNESAW PEDIATRICS |
| Practice Address |
3745 Cherokee St Nw Suite 401 Kennesaw GA 30144-6733 |
| Practice Telephone | 7704291005 |
| Practice Fax Number | 7704298005 |
| Mailing Telephone | 7704291005 |
| Mailing Fax Number | 7704298005 |
| Enumeration Date | 2007-09-04 |
| Last Update Date | 2007-09-04 |
| Authorized Official Name | DR. MARK ANTHONY LONG (PRESIDENT) |
| Authorized Official Telephone | 7704291005 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
0048265 | GA | Ambulatory Health Care Facilities |
| Street Address |
3745 CHEROKEE ST NW SUITE 401 |
| City | KENNESAW |
| State | GA |
| Zip Code | 30144-6733 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740264837 | Mark R Hester | Optometrist | 3745 Cherokee St Nw, Ste 404, Kennesaw, GA 30144-6733 | 2005-12-01 |
| 1184230864 | Mary Elizabeth Moore | Nurse Practitioner | 3745 Cherokee St Nw, Kennesaw, GA 30144-6733 | 2020-09-18 |
| 1013365055 | Cobb Pharmacy, Inc | Pharmacy | 3745 Cherokee St Nw, Suite 603, Kennesaw, GA 30144-6733 | 2016-06-01 |
| 1821329343 | Chronic Health Management, LLC | Durable Medical Equipment & Medical Supplies | 3745 Cherokee St Nw, Suite 102, Kennesaw, GA 30144-6733 | 2010-01-22 |
| 1073717278 | Hester Eye Associates, PC | Optometrist | 3745 Cherokee St Nw, Ste 404, Kennesaw, GA 30144-6733 | 2007-06-12 |
| 1497959910 | Sarah Elizabeth Yount | Pediatrics | 3745 Cherokee St Nw, Suite401, Kennesaw, GA 30144-6733 | 2007-06-11 |
| 1609902543 | Elizabeth Maddox Kresge | Counselor | 3745 Cherokee St Nw, Suite 202, Kennesaw, GA 30144-6733 | 2007-02-26 |
| 1649359936 | Philip Lloyd Wright | Chiropractor | 3745 Cherokee St Nw, # 606, Kennesaw, GA 30144-6733 | 2006-11-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205440054 | Physician Assistant Surgical Solutions | Surgery | 4290 Bells Ferry Road, Suite 134 - 1032, Kennesaw, GA 30144 | 2020-08-31 |
| 1487149340 | Creative Family Care Inc. | Social Worker | 1275 Shiloh Rd Nw Ste 3030, Kennesaw, GA 30144 | 2018-06-24 |
| 1033632203 | Octavio Andres Tobar | Specialist/Technologist | 1950 Barrett Lakes Blvd Nw Apt 1213, Kennesaw, GA 30144 | 2017-07-19 |
| 1851829220 | Sharon Mcmillan | Counselor | 1301 Shiloh Rd Nw Ste 1840, Kennesaw, GA 30144 | 2017-05-31 |
| 1073054680 | Metropolitan Health Care Plus Inc | Home Health | 445 Laurian Way, Kennesaw, GA 30144 | 2017-03-15 |
| 1649627969 | Caresouth Hha Holdings of Gainesville, LLC | Hospice Care, Community Based | 1000 Cobb Place Blvd Nw Ste 310, Kennesaw, GA 30144 | 2016-05-17 |
| 1851745988 | Joseph Mulligan | Social Worker | 1301 Shiloh Rd., Ste. 849, Kennesaw, GA 30144 | 2016-04-14 |
| 1629438601 | Youfit Health Clubs | Clinic/Center | 3895 Cherokee St Suite 100, Kennesaw, GA 30144 | 2016-03-03 |
| 1598156317 | Jodie Evans | Specialist | 1925 Vaughn Rd, Ste 200, Kennesaw, GA 30144 | 2015-02-16 |
| 1912302134 | Sleepmed Therapies, Inc. | Durable Medical Equipment & Medical Supplies | 1000 Cobb Place Blvd Nw Ste 510, Kennesaw, GA 30144 | 2014-10-30 |
| Find all providers in zip 30144 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366061699 | Beyondmed LLC | Clinic/Center | 1820 Willow Branch Ln Nw, Kennesaw, GA 30152-4558 | 2020-04-16 |
| 1477939676 | Stepping Stone Pediatrics, LLC | Clinic/Center | 1770 Dennis Kemp Ln Nw, Kennesaw, GA 30152-3938 | 2015-08-11 |
| 1235378324 | Kennesaw Mountain Medical Group | Clinic/Center | 1600 Kennesaw Due West Rd Nw, Building 600 Suite 625, Kennesaw, GA 30152-4301 | 2009-02-12 |
| 1285786541 | Acworth Family Medicine, PC | Clinic/Center | 5150 Stilesboro Rd Nw, Suite 120, Kennesaw, GA 30152-7744 | 2007-01-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942809108 | Lexington Primary Care LLC | Clinic/Center | 777 Athens Rd, Lexington, GA 30648-1902 | 2020-10-20 |
| 1619575834 | The Iv Spot, LLC. | Clinic/Center | 2100 Parklake Dr Ne # C-5, Atlanta, GA 30345-2824 | 2020-10-09 |
| 1528673514 | Safe Haven Medical Services | Clinic/Center | 444 Racetrack Rd, Mcdonough, GA 30252-6837 | 2020-09-15 |
| 1780296533 | North Atlanta Mental Wellness | Clinic/Center | 1742 Mount Vernon Rd Ste 150b, Atlanta, GA 30338-4251 | 2020-08-21 |
| 1639788136 | Walker Health and Wellness LLC | Clinic/Center | 111 Bradford Dr, Bloomingdale, GA 31302-4926 | 2020-07-30 |
| 1942827332 | Primary Care of Coastal Georgia | Clinic/Center | 214a Professional Cir, St Marys, GA 31558 | 2020-07-01 |
| 1598389637 | Mercie Health | Clinic/Center | 3721 New Macland Rd Ste 246, Powder Springs, GA 30127-2000 | 2020-06-04 |
| 1366082596 | Rock Health Inc | Clinic/Center | 5385 Five Forks Trickum Rd Ste F, Stone Mountain, GA 30087-3018 | 2020-01-15 |
| 1477192219 | Meridian Corporate Healthcare of Georgia P C | Clinic/Center | 5163 Thompson Bridge Rd, Murrayville, GA 30564-1930 | 2019-12-26 |
| 1417593047 | Integrative Medical Group and Medical Spa, Inc | Clinic/Center | 805 Lambert Dr Ne Ste C, Atlanta, GA 30324-4189 | 2019-11-19 |
| 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.