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SOUTHERN CRESCENT PEDIATRICS PC
NPI 1437145950
Pediatrics in Ellenwood, GA

Active since September 20, 2005
191 FAIRVIEW RD, ELLENWOOD, GA 30294(770) 389-5500(770) 389-4959 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Southern Crescent Pediatrics Pc NPPES

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

SOUTHERN CRESCENT PEDIATRICS PC (NPI 1437145950) is a healthcare organization registered as a pediatrics in Ellenwood, Georgia and active in the NPI registry since September 2005. The organization lists Juan Jose Sherwood, President, as its authorized official.

NPPES Registry Identity

NPI1437145950
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameSOUTHERN CRESCENT PEDIATRICS PC
Location Address191 FAIRVIEW RDEllenwood, GA 30294-2722
Mailing Address150 Medical Blvd, Ste BStockbridge, GA 30281-5053 · (770) 389-9944 · Fax (770) 389-1973
Phone(770) 389-5500
Fax(770) 389-4959
Organization SubpartNo
Authorized OfficialJuan Jose SherwoodPresident · (770) 389-9944
Enumeration DateSeptember 20, 2005
Last NPPES UpdateAugust 22, 2020
✔ NPI 1437145950 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.
191 FAIRVIEW RD, Ellenwood, GA 30294
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Other Identifiers 3

Other7802Kaiser Pos
Other0526682Aetna Select/us Healthc
Other276714Bcbs

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

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 Southern Crescent Pediatrics PC's NPI number?

The NPI number for Southern Crescent Pediatrics PC is 1437145950. It was assigned to this organization in the NPPES registry on September 20, 2005.

Where is Southern Crescent Pediatrics PC located?

Southern Crescent Pediatrics PC is located at 191 Fairview Rd, Ellenwood, GA 30294. The listed phone number is (770) 389-5500.

What is Southern Crescent Pediatrics PC's specialty?

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

When was this NPI record last updated?

The NPPES record for Southern Crescent Pediatrics PC was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.