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KIDS-DOC-ON-WHEELS
NPI 1497277404
Pediatrics in Clarkston, GA

Active since July 11, 2017
4112 E PONCE DE LEON AVE # 2, CLARKSTON, GA 30021(404) 574-2512(404) 296-7211 Get Directions Write a Review

NPPES record last updated: December 14, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 14, 2017, Oct 27, 2017, Jul 11, 2017 (3 updates tracked since 2017).

About Kids-doc-on-wheels NPPES

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

KIDS-DOC-ON-WHEELS (NPI 1497277404) is a healthcare organization registered as a pediatrics in Clarkston, Georgia and active in the NPI registry since July 2017. The organization maintains a secondary practice location in Clarkston and lists Lynette R Wilson-phillips, Board Of Directors, as its authorized official.

NPPES Registry Identity

NPI1497277404
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameKIDS-DOC-ON-WHEELS
Location Address4112 E PONCE DE LEON AVE # 2Clarkston, GA 30021-8106
Mailing Address4112 E Ponce De Leon Ave # 2Clarkston, GA 30021-8106 · (404) 574-2512 · Fax (404) 296-7211
Phone(404) 574-2512
Fax(404) 296-7211
Organization SubpartNo
Authorized OfficialLynette R Wilson-phillipsBoard Of Directors · (404) 574-2512
Enumeration DateJuly 11, 2017
Last NPPES UpdateDecember 14, 20173 updates tracked since enumeration
✔ NPI 1497277404 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.
4112 E PONCE DE LEON AVE # 2, Clarkston, GA 30021
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Secondary Practice Location 1

Location 14112 E Ponce De Leon Ave # 2Clarkston, GA 30021-8106 · Phone (404) 574-2512 · Fax (404) 296-7211

Other Identifiers 1

Medicaid003193946AGA

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

Accepted Insurance

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

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 Kids-Doc-On-Wheels's NPI number?

The NPI number for Kids-Doc-On-Wheels is 1497277404. It was assigned to this organization in the NPPES registry on July 11, 2017.

Where is Kids-Doc-On-Wheels located?

Kids-Doc-On-Wheels is located at 4112 E Ponce De Leon Ave # 2, Clarkston, GA 30021. The listed phone number is (404) 574-2512.

What is Kids-Doc-On-Wheels's specialty?

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

What insurance does Kids-Doc-On-Wheels accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Kids-Doc-On-Wheels 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 Kids-Doc-On-Wheels was last updated on December 14, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.