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

Q: What is the provider's specialty?

The provider's specialty is Clinic/Center with taxonomy code 261QP2300X and a focus in Primary Care.

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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.

DR. KYOUNG-SOON KIM MD

Pediatrics