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KALEIDOSCOPE PEDIATRICS PC
NPI 1407045495
Pediatrics - Adolescent Medicine in Marietta, GA

Active since October 16, 2007
1523 JOHNSON FERRY RD, SUITE 150, MARIETTA, GA 30062(770) 509-1234 Get Directions Write a Review

NPPES record last updated: October 16, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Kaleidoscope Pediatrics Pc NPPES

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

KALEIDOSCOPE PEDIATRICS PC (NPI 1407045495) is a healthcare organization registered as an adolescent medicine in Marietta, Georgia and active in the NPI registry since October 2007. The organization lists Susan Gail Staviss, President, as its authorized official.

NPPES Registry Identity

NPI1407045495
Entity TypeOrganization
Primary Taxonomy2080A0000X
Legal Business NameKALEIDOSCOPE PEDIATRICS PC
Location Address1523 JOHNSON FERRY RD, SUITE 150Marietta, GA 30062-6438
Mailing Address1523 Johnson Ferry Rd, Suite 150Marietta, GA 30062-6438 · (770) 509-1234
Phone(770) 509-1234
Organization SubpartNo
Authorized OfficialSusan Gail StavissPresident · (770) 509-1234
Enumeration DateOctober 16, 2007
✔ NPI 1407045495 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Adolescent MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080A0000X
Definition
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.
1523 JOHNSON FERRY RD, Marietta, GA 30062
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Other Identifiers 1

Other52478249004GA · Blue Cross Blue Shield

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

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. WHITNEY S DENTON M.D.
Family Medicine
1523 JOHNSON FERRY RD, SUITE 150
MARIETTA, GA 30062
Cobb County (678) 403-4660

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 Kaleidoscope Pediatrics PC's NPI number?

The NPI number for Kaleidoscope Pediatrics PC is 1407045495. It was assigned to this organization in the NPPES registry on October 16, 2007.

Where is Kaleidoscope Pediatrics PC located?

Kaleidoscope Pediatrics PC is located at 1523 Johnson Ferry Rd Suite 150, Marietta, GA 30062. The listed phone number is (770) 509-1234.

What is Kaleidoscope Pediatrics PC's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Adolescent Medicine, with taxonomy code 2080A0000X.

When was this NPI record last updated?

The NPPES record for Kaleidoscope Pediatrics PC was last updated on October 16, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.