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KENNESAW PEDIATRICS
NPI 1659565562
Clinic/Center - Primary Care in Kennesaw, GA

Active since September 04, 2007CLIA 11D1010647 · Waiver
3745 CHEROKEE ST NW, SUITE 401, KENNESAW, GA 30144(770) 429-1005(770) 429-8005 Get Directions Write a Review

NPPES record last updated: September 4, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Kennesaw Pediatrics NPPES

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

KENNESAW PEDIATRICS (NPI 1659565562) is a healthcare organization registered as a primary care in Kennesaw, Georgia and active in the NPI registry since September 2007. The organization holds a CLIA Waiver certificate valid through May 31, 2027 and lists Mark Anthony Long, President, as its authorized official.

NPPES Registry Identity

NPI1659565562
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameKENNESAW PEDIATRICS
Location Address3745 CHEROKEE ST NW, SUITE 401Kennesaw, GA 30144-6733
Mailing Address3745 Cherokee St Nw, Suite 401Kennesaw, GA 30144-6733 · (770) 429-1005 · Fax (770) 429-8005
Phone(770) 429-1005
Fax(770) 429-8005
Organization SubpartNo
Authorized OfficialMark Anthony LongPresident · (770) 429-1005
Enumeration DateSeptember 4, 2007
✔ NPI 1659565562 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 · 0048265
3745 CHEROKEE ST NW, Kennesaw, GA 30144
Open in Google Maps ↗

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 ›

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 11D1010647

Kennesaw Pediatrics PC · Kennesaw, GA
Active · expires May 31, 2027
CLIA Number11D1010647
Laboratory TypePhysician Office
Certificate Effective DateJune 1, 2025
Certificate Expiration DateMay 31, 2027
Laboratory DirectorMark A. Long
Laboratory Phone(770) 429-1005
Laboratory LocationKennesaw Pediatrics PC3745 Cherokee Street, Suite 401, Kennesaw, GA 30144
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 9

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

COBB PHARMACY, INC
Pharmacy (Community/Retail Pharmacy)
3745 CHEROKEE ST NW, SUITE 603
KENNESAW, GA 30144
Cobb County (404) 252-8031
HESTER EYE ASSOCIATES, PC
Optometrist
3745 CHEROKEE ST NW, STE 404
KENNESAW, GA 30144
Cobb County (770) 590-8191
DR. SARAH ELIZABETH YOUNT MD
Pediatrics
3745 CHEROKEE ST NW, SUITE401
KENNESAW, GA 30144
Cobb County (770) 429-1005
MRS. ELIZABETH MADDOX KRESGE
Counselor (Professional)
3745 CHEROKEE ST NW, SUITE 202
KENNESAW, GA 30144
Cobb County (404) 944-9431
DR. PHILIP LLOYD WRIGHT DC
Chiropractor
3745 CHEROKEE ST NW, # 606
KENNESAW, GA 30144
Cobb County (770) 795-3144
SHANA SHELBY ADKINS M.S., LPC, CRC, NCC
Counselor (Professional)
3745 CHEROKEE ST NW
KENNESAW, GA 30144
Cobb County (770) 499-0140
ALLISON PAIGE ARBELAEZ LCSW
Social Worker (Clinical)
3745 CHEROKEE ST NW
KENNESAW, GA 30144
Cobb County (770) 499-0140
MARK R HESTER OD
Optometrist
3745 CHEROKEE ST NW, STE 404
KENNESAW, GA 30144
Cobb County (770) 590-8191

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 Kennesaw Pediatrics's NPI number?

The NPI number for Kennesaw Pediatrics is 1659565562. It was assigned to this organization in the NPPES registry on September 4, 2007.

Where is Kennesaw Pediatrics located?

Kennesaw Pediatrics is located at 3745 Cherokee St NW Suite 401, Kennesaw, GA 30144. The listed phone number is (770) 429-1005.

What is Kennesaw Pediatrics's specialty?

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

Does Kennesaw Pediatrics hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D1010647) is associated with this NPI, valid through May 31, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Kennesaw Pediatrics accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Kennesaw Pediatrics 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 Kennesaw Pediatrics was last updated on September 4, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.