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TRINITY PEDIATRIC MEDICINE OF COLLEGE PARK, LLC
NPI 1396410882
Pediatrics in Atlanta, GA

Active since August 16, 2021CLIA 11D2282667 · Waiver
6524 OLD NATIONAL HWY, BLDG. B, STE 102, ATLANTA, GA 30349(678) 472-3734 Get Directions Write a Review

NPPES record last updated: August 16, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Trinity Pediatric Medicine Of College Park, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TRINITY PEDIATRIC MEDICINE OF COLLEGE PARK, LLC (NPI 1396410882) is a healthcare organization registered as a pediatrics in Atlanta, Georgia and active in the NPI registry since August 2021. The organization holds a CLIA Waiver certificate valid through May 23, 2027 and lists Carina Gibbs, Cfo, as its authorized official.

NPPES Registry Identity

NPI1396410882
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameTRINITY PEDIATRIC MEDICINE OF COLLEGE PARK, LLC
Location Address6524 OLD NATIONAL HWY, BLDG. B, STE 102Atlanta, GA 30349
Mailing Address6524 Old National Hwy, Bldg. B, Ste 102Atlanta, GA 30349 · (678) 472-3734
Phone(678) 472-3734
Organization SubpartNo
Authorized OfficialCarina GibbsCfo · (678) 472-3734
Enumeration DateAugust 16, 2021
NPPES CertifiedAugust 16, 2021
✔ NPI 1396410882 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
6524 OLD NATIONAL HWY, Atlanta, GA 30349
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Other Identifiers 1

Other1407950876GA · Pediatric Medicine

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D2282667

Trinity Pediatric Medicine Of College Park · Atlanta, GA
Active · expires May 23, 2027
CLIA Number11D2282667
Laboratory TypePhysician Office
Certificate Effective DateMay 24, 2025
Certificate Expiration DateMay 23, 2027
Laboratory DirectorTeddi Virgil
Laboratory Phone(770) 615-0999
Laboratory LocationTrinity Pediatric Medicine Of College Park6524 Old National Highway, Suite 202, Atlanta, GA 30349
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Trinity Pediatric Medicine Of College Park, LLC's NPI number?

The NPI number for Trinity Pediatric Medicine Of College Park, LLC is 1396410882. It was assigned to this organization in the NPPES registry on August 16, 2021.

Where is Trinity Pediatric Medicine Of College Park, LLC located?

Trinity Pediatric Medicine Of College Park, LLC is located at 6524 Old National Hwy Bldg. B, Ste 102, Atlanta, GA 30349. The listed phone number is (678) 472-3734.

What is Trinity Pediatric Medicine Of College Park, LLC's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Trinity Pediatric Medicine Of College Park, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2282667) is associated with this NPI, valid through May 23, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Trinity Pediatric Medicine Of College Park, LLC was last updated on August 16, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.