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VIBRANT KIDS PEDIATRICS, LLC
NPI 1811241417
Clinic/Center in Newnan, GA

Active since November 04, 2012CLIA 11D2051267 · Waiver
10 MARKET SQUARE WAY STE 100, NEWNAN, GA 30265(678) 423-5560(678) 423-5563 Get Directions Write a Review

NPPES record last updated: November 4, 2012. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Vibrant Kids Pediatrics, Llc NPPES

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

VIBRANT KIDS PEDIATRICS, LLC (NPI 1811241417) is a healthcare organization registered as a clinic/center in Newnan, Georgia and active in the NPI registry since November 2012. The organization holds a CLIA Waiver certificate valid through December 16, 2026 and lists Jill Burnett Dickerson, Manager, as its authorized official.

NPPES Registry Identity

NPI1811241417
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameVIBRANT KIDS PEDIATRICS, LLC
Location Address10 MARKET SQUARE WAY STE 100Newnan, GA 30265-6078
Mailing Address87 Tapestry LnNewnan, GA 30265-5649 · (678) 423-5560 · Fax (678) 423-5563
Phone(678) 423-5560
Fax(678) 423-5563
Organization SubpartNo
Authorized OfficialJill Burnett DickersonManager · (678) 423-5560
Enumeration DateNovember 4, 2012
✔ NPI 1811241417 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
License✔ Licensed in GA · 061061
Definition

A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

10 MARKET SQUARE WAY STE 100, Newnan, GA 30265
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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 11D2051267

Vibrant Kids Pediatrics, LLC · Newnan, GA
Active · expires Dec 16, 2026
CLIA Number11D2051267
Laboratory TypePhysician Office
Certificate Effective DateDecember 17, 2024
Certificate Expiration DateDecember 16, 2026
Laboratory DirectorJill B. Dickerson
Laboratory Phone(678) 423-5560
Laboratory LocationVibrant Kids Pediatrics, LLC10 Market Square Way, Suite 100, Newnan, GA 30265
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 2

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

DR. JILL B DICKERSON M.D.
Pediatrics
10 MARKET SQUARE WAY STE 100
NEWNAN, GA 30265
Coweta County (678) 423-5560
LEXIS LANGNER RIEHL NP
Nurse Practitioner (Pediatrics)
10 MARKET SQUARE WAY STE 100
NEWNAN, GA 30265
Coweta County (678) 423-5560

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 Vibrant Kids Pediatrics, LLC's NPI number?

The NPI number for Vibrant Kids Pediatrics, LLC is 1811241417. It was assigned to this organization in the NPPES registry on November 4, 2012.

Where is Vibrant Kids Pediatrics, LLC located?

Vibrant Kids Pediatrics, LLC is located at 10 Market Square Way Ste 100, Newnan, GA 30265. The listed phone number is (678) 423-5560.

What is Vibrant Kids Pediatrics, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Does Vibrant Kids Pediatrics, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2051267) is associated with this NPI, valid through December 16, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Vibrant Kids Pediatrics, LLC was last updated on November 4, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.