CAMP CREEK PEDIATRICS
NPI 1891065504
Pediatrics in Fayetteville, GA

Q: What is Camp Creek Pediatrics's NPI number?

The NPI number for Camp Creek Pediatrics is 1891065504. It was assigned to this organization in the NPPES registry on January 11, 2012. The provider was formerly known as Charlene Johnson, MD.

Q: What is Camp Creek Pediatrics's specialty?

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

Active since January 11, 2012CLIA 11D0929379 · Waiver

495 VIRGINIA HIGHLANDS, FAYETTEVILLE, GA 30215(770) 460-6459 Get Directions Write a Review

NPPES record last updated: January 11, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Camp Creek Pediatrics NPPES

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

CAMP CREEK PEDIATRICS (NPI 1891065504), doing business as Charlene Johnson, Md, is a healthcare organization registered as a pediatrics in Fayetteville, Georgia and active in the NPI registry since January 2012. The organization holds a CLIA Waiver certificate valid through June 11, 2027 and lists Kathy Ann Dyson, Billing Manager, as its authorized official.

NPPES Registry Identity

NPI1891065504

Entity TypeOrganization

Primary Taxonomy208000000X

Legal Business NameCAMP CREEK PEDIATRICS

Location Address495 VIRGINIA HIGHLANDSFayetteville, GA 30215-8233

Mailing Address2945 Stone Hogan Connector Rd Sw Ste 201Atlanta, GA 30331-2839 · (404) 349-6758 · Fax (404) 349-6759

Phone(770) 460-6459

Organization SubpartNo

Authorized OfficialKathy Ann DysonBilling Manager · (770) 745-1070

Enumeration DateJanuary 11, 2012

✔ NPI 1891065504 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in GA · 049655

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.

495 VIRGINIA HIGHLANDS, Fayetteville, GA 30215

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Other Names 1

Former Legal Business NameCharlene Johnson, Md

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 ›

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 11D0929379

Camp Creek Pediatrics · Atlanta, GA

Active · expires Jun 11, 2027

CLIA Number11D0929379

Laboratory TypePhysician Office

Certificate Effective DateJune 12, 2025

Certificate Expiration DateJune 11, 2027

Laboratory DirectorDr. Charlene Johnson

Laboratory Phone(404) 349-6758

Laboratory LocationCamp Creek Pediatrics3886 Princeton Lakes Way, Suite 260, Atlanta, GA 30331

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only 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 Camp Creek Pediatrics's NPI number?

The NPI number for Camp Creek Pediatrics is 1891065504. It was assigned to this organization in the NPPES registry on January 11, 2012. The provider was formerly known as Charlene Johnson, MD.

Where is Camp Creek Pediatrics located?

Camp Creek Pediatrics is located at 495 Virginia Highlands, Fayetteville, GA 30215. The listed phone number is (770) 460-6459.

What is Camp Creek Pediatrics's specialty?

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

Does Camp Creek Pediatrics hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D0929379) is associated with this NPI, valid through June 11, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Camp Creek Pediatrics accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Camp Creek 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 Camp Creek Pediatrics was last updated on January 11, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.