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STEPPING STONE PEDIATRICS, LLC
NPI 1477939676
Clinic/Center - Primary Care in Kennesaw, GA

Active since August 11, 2015CLIA 11D2103185 · Waiver
1770 DENNIS KEMP LN NW, KENNESAW, GA 30152(770) 515-9000(678) 813-3355 Get Directions Write a Review

NPPES record last updated: August 11, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Stepping Stone Pediatrics, Llc NPPES

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

STEPPING STONE PEDIATRICS, LLC (NPI 1477939676) is a healthcare organization registered as a primary care in Kennesaw, Georgia and active in the NPI registry since August 2015. The organization holds a CLIA Waiver certificate valid through October 6, 2027 and lists Kyoung-soon Kim, Managing Partner, as its authorized official.

NPPES Registry Identity

NPI1477939676
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameSTEPPING STONE PEDIATRICS, LLC
Location Address1770 DENNIS KEMP LN NWKennesaw, GA 30152-3938
Mailing Address1770 Dennis Kemp Ln NwKennesaw, GA 30152-3938 · (770) 515-9000 · Fax (678) 813-3355
Phone(770) 515-9000
Fax(678) 813-3355
Organization SubpartNo
Authorized OfficialKyoung-soon KimManaging Partner · (770) 862-1166
Enumeration DateAugust 11, 2015
✔ NPI 1477939676 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
License✔ Licensed in GA · 039144
1770 DENNIS KEMP LN NW, Kennesaw, GA 30152
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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 11D2103185

Stepping Stone Pediatrics, LLC · Kennesaw, GA
Active · expires Oct 6, 2027
CLIA Number11D2103185
Laboratory TypePhysician Office
Certificate Effective DateOctober 7, 2025
Certificate Expiration DateOctober 6, 2027
Laboratory DirectorKyoungsoon Kim
Laboratory Phone(770) 515-9000
Laboratory LocationStepping Stone Pediatrics, LLC1770 Dennis Kemp Lane, Kennesaw, GA 30152
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 7

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

MS. TANYA S WILCOX NP
Nurse Practitioner (Pediatrics)
1770 DENNIS KEMP LN NW
KENNESAW, GA 30152
Cobb County (770) 515-9000
SARAH MITCHUM KEEN RN
Nurse Practitioner (Pediatrics)
1770 DENNIS KEMP LN NW
KENNESAW, GA 30152
Cobb County (770) 515-9000
MARY ELIZABETH GRAVES PNP
Nurse Practitioner (Pediatrics)
1770 DENNIS KEMP LN NW
KENNESAW, GA 30152
Cobb County (770) 515-9000
JAMIE MARIE CONWELL
Nurse Practitioner (Pediatrics)
1770 DENNIS KEMP LN NW
KENNESAW, GA 30152
Cobb County (707) 515-9000
EMERY DELANCEY DIKEMAN MSN, APRN, CPNP-PC
Nurse Practitioner (Pediatrics)
1770 DENNIS KEMP LN NW
KENNESAW, GA 30152
Cobb County (770) 515-9000
DR. KYOUNG-SOON KIM MD
Pediatrics
1770 DENNIS KEMP LN NW
KENNESAW, GA 30152
Cobb County (770) 515-9000
HILERE WELCH PASLEY
Nurse Practitioner (Pediatrics)
1770 DENNIS KEMP LN NW
KENNESAW, GA 30152
Cobb County (770) 515-9000

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 Stepping Stone Pediatrics, LLC's NPI number?

The NPI number for Stepping Stone Pediatrics, LLC is 1477939676. It was assigned to this organization in the NPPES registry on August 11, 2015.

Where is Stepping Stone Pediatrics, LLC located?

Stepping Stone Pediatrics, LLC is located at 1770 Dennis Kemp Ln NW, Kennesaw, GA 30152. The listed phone number is (770) 515-9000.

What is Stepping Stone Pediatrics, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does Stepping Stone Pediatrics, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2103185) is associated with this NPI, valid through October 6, 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 Stepping Stone Pediatrics, LLC was last updated on August 11, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.