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KIDCARE PEDIATRICS
NPI 1417044181
Pediatrics in Atlanta, GA

Active since October 06, 2006CLIA 11D0921567 · Waiver
910 DANNON VW SW STE 2101, ATLANTA, GA 30331(404) 691-6100(404) 691-6959 Get Directions Write a Review

NPPES record last updated: September 16, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 16, 2020, Aug 22, 2020 (2 updates tracked since 2020).

About Kidcare Pediatrics NPPES

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

KIDCARE PEDIATRICS (NPI 1417044181) is a healthcare organization registered as a pediatrics in Atlanta, Georgia and active in the NPI registry since October 2006. The organization holds a CLIA Waiver certificate valid through February 11, 2027 and lists Chauncey Daniels, Ceo, as its authorized official.

NPPES Registry Identity

NPI1417044181
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameKIDCARE PEDIATRICS
Location Address910 DANNON VW SW STE 2101Atlanta, GA 30331-2156
Mailing Address910 Dannon Vw Sw Ste 2101Atlanta, GA 30331-2156 · (404) 691-6100 · Fax (404) 691-6959
Phone(404) 691-6100
Fax(404) 691-6959
Organization SubpartNo
Authorized OfficialChauncey DanielsCeo · (404) 765-9437
Enumeration DateOctober 6, 2006
Last NPPES UpdateSeptember 16, 20202 updates tracked since enumeration
NPPES CertifiedSeptember 16, 2020
✔ NPI 1417044181 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ 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.
Also ListedHealth Maintenance OrganizationTaxonomy 302R00000X · License 057447 (GA)
910 DANNON VW SW STE 2101, Atlanta, GA 30331
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Other Identifiers 1

Medicaid000359675HGA

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 11D0921567

Kidcare Pediatrics LLC · College Park, GA
Active · expires Feb 11, 2027
CLIA Number11D0921567
Laboratory TypePhysician Office
Certificate Effective DateFebruary 12, 2025
Certificate Expiration DateFebruary 11, 2027
Laboratory DirectorHelena Bentley MD
Laboratory Phone(404) 691-6100
Laboratory LocationKidcare Pediatrics LLC2565 Jolly Road, Suite A & B, College Park, GA 30349
CLIA data matches this NPI record on: Name Phone
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 Kidcare Pediatrics's NPI number?

The NPI number for Kidcare Pediatrics is 1417044181. It was assigned to this organization in the NPPES registry on October 6, 2006.

Where is Kidcare Pediatrics located?

Kidcare Pediatrics is located at 910 Dannon Vw SW Ste 2101, Atlanta, GA 30331. The listed phone number is (404) 691-6100.

What is Kidcare Pediatrics's specialty?

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

Does Kidcare Pediatrics hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D0921567) is associated with this NPI, valid through February 11, 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 Kidcare Pediatrics was last updated on September 16, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.