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SUWANEE PEDIATRICS PC
NPI 1487886123
Clinic/Center - Primary Care in Lawrenceville, GA

Active since August 13, 2009CLIA 11D0966273 · Waiver
1155 LAWRENCEVILLE SUWANEE RD, LAWRENCEVILLE, GA 30043(678) 442-0205(678) 442-0185 Get Directions Write a Review

NPPES record last updated: February 25, 2011. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Suwanee Pediatrics Pc NPPES

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

SUWANEE PEDIATRICS PC (NPI 1487886123) is a healthcare organization registered as a primary care in Lawrenceville, Georgia and active in the NPI registry since August 2009. The organization holds a CLIA Waiver certificate valid through October 11, 2027 and lists Bolaji T Odusina, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1487886123
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameSUWANEE PEDIATRICS PC
Location Address1155 LAWRENCEVILLE SUWANEE RDLawrenceville, GA 30043-5425
Mailing Address1155 Lawrenceville Suwanee RdLawrenceville, GA 30043-5425 · (678) 442-0205 · Fax (678) 442-0185
Phone(678) 442-0205
Fax(678) 442-0185
Organization SubpartNo
Authorized OfficialBolaji T OdusinaMedical Director · (678) 442-0205
Enumeration DateAugust 13, 2009
Last NPPES UpdateFebruary 25, 2011
✔ NPI 1487886123 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 · 042380
1155 LAWRENCEVILLE SUWANEE RD, Lawrenceville, GA 30043
Open in Google Maps ↗

Other Identifiers 4

Medicare UPINF86425GA
Medicaid000757567BGA
Medicare PIN37BBGGNGA
Medicaid647974880BGA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health and more.Insurance ›

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 11D0966273

Suwanee Pediatrics LLC · Lawrenceville, GA
Active · expires Oct 11, 2027
CLIA Number11D0966273
Laboratory TypePhysician Office
Certificate Effective DateOctober 12, 2025
Certificate Expiration DateOctober 11, 2027
Laboratory DirectorBolaji T. Odusina MD
Laboratory Phone(678) 442-0205
Laboratory LocationSuwanee Pediatrics LLC1155 Lawrenceville-Suwanee Road, Lawrenceville, GA 30043
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 5

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

KATHERINE A NGUYEN FNP-BC
Nurse Practitioner
1155 LAWRENCEVILLE SUWANEE RD
LAWRENCEVILLE, GA 30043
Gwinnett County (678) 442-0205
MS. STEPHANIE EVELYN SNIPES PHYSICIAN ASSISTANT
Physician Assistant
1155 LAWRENCEVILLE SUWANEE RD
LAWRENCEVILLE, GA 30043
Gwinnett County (678) 442-0205
ERIN ASHLEY COX CPNP-PC
Nurse Practitioner (Pediatrics)
1155 LAWRENCEVILLE SUWANEE RD
LAWRENCEVILLE, GA 30043
Gwinnett County (678) 442-0205
BOLAJI T ODUSINA MD
Pediatrics
1155 LAWRENCEVILLE SUWANEE RD
LAWRENCEVILLE, GA 30043
Gwinnett County (678) 442-0205
OANH NGOC THI TRAN NP
Nurse Practitioner (Pediatrics)
1155 LAWRENCEVILLE SUWANEE RD
LAWRENCEVILLE, GA 30043
Gwinnett County (678) 422-0205

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 Suwanee Pediatrics PC's NPI number?

The NPI number for Suwanee Pediatrics PC is 1487886123. It was assigned to this organization in the NPPES registry on August 13, 2009.

Where is Suwanee Pediatrics PC located?

Suwanee Pediatrics PC is located at 1155 Lawrenceville Suwanee Rd, Lawrenceville, GA 30043. The listed phone number is (678) 442-0205.

What is Suwanee Pediatrics PC's specialty?

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

Does Suwanee Pediatrics PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D0966273) is associated with this NPI, valid through October 11, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Suwanee Pediatrics PC accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list Suwanee Pediatrics PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Suwanee Pediatrics PC was last updated on February 25, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.