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CREEKSIDE MEDICAL CLINIC LLC
NPI 1518289248
Family Medicine in Kennesaw, GA

Active since February 22, 2010CLIA 11D2004020 · Microscopy
3104 CREEKSIDE VILLAGE DR NW, SUITE 201, KENNESAW, GA 30144(770) 627-3986(770) 872-0517 Get Directions Write a Review

NPPES record last updated: August 15, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Creekside Medical Clinic Llc NPPES

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

CREEKSIDE MEDICAL CLINIC LLC (NPI 1518289248) is a healthcare organization registered as a family medicine in Kennesaw, Georgia and active in the NPI registry since February 2010. The organization holds a CLIA Microscopy certificate valid through February 23, 2028 and lists Sharmila Ramprasad, Director, as its authorized official.

NPPES Registry Identity

NPI1518289248
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameCREEKSIDE MEDICAL CLINIC LLC
Location Address3104 CREEKSIDE VILLAGE DR NW, SUITE 201Kennesaw, GA 30144-2324
Mailing Address3104 Creekside Village Dr Nw, Suite 201Kennesaw, GA 30144-2324 · (770) 627-3986 · Fax (770) 872-0517
Phone(770) 627-3986
Fax(770) 872-0517
Organization SubpartNo
Authorized OfficialSharmila RamprasadDirector · (770) 627-3986
Enumeration DateFebruary 22, 2010
Last NPPES UpdateAugust 15, 2022
NPPES CertifiedAugust 15, 2022
✔ NPI 1518289248 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
3104 CREEKSIDE VILLAGE DR NW, Kennesaw, GA 30144
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Other Identifiers 1

Medicaid839516023AGA

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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Creekside Medical Clinic Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Creekside Medical Clinic LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Sharmila Ramprasad, M.D.
Family Practice
NPI 1093724908
3104 CREEKSIDE VILLAGE DR NW SUITE 201
Kennesaw, GA 30144
(770) 627-3986
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 for Provider-Performed Microscopy Procedures (PPMP) 11D2004020

Creekside Medical Clinic, LLC · Kennesaw, GA
Active · expires Feb 23, 2028
CLIA Number11D2004020
Laboratory TypePhysician Office
Certificate Effective DateFebruary 24, 2026
Certificate Expiration DateFebruary 23, 2028
Laboratory DirectorSharmila Ramprased
Laboratory Phone(770) 627-3986
Laboratory LocationCreekside Medical Clinic, LLC3104 Creekside Village Drive, #201, Kennesaw, GA 30144
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

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 Creekside Medical Clinic LLC's NPI number?

The NPI number for Creekside Medical Clinic LLC is 1518289248. It was assigned to this organization in the NPPES registry on February 22, 2010.

Where is Creekside Medical Clinic LLC located?

Creekside Medical Clinic LLC is located at 3104 Creekside Village Dr NW Suite 201, Kennesaw, GA 30144. The listed phone number is (770) 627-3986.

What is Creekside Medical Clinic LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Creekside Medical Clinic LLC enrolled in Medicare?

Yes. Creekside Medical Clinic LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Creekside Medical Clinic LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Creekside Medical Clinic LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Creekside Medical Clinic LLC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 11D2004020) is associated with this NPI, valid through February 23, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Creekside Medical Clinic LLC was last updated on August 15, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.