KIDS AVENUE PEDIATRICS LLC – Pediatrics Physician, NPI 1801057609

KIDS AVENUE PEDIATRICS LLC is a healthcare provider. based in College park, Georgia. specializing in Pediatrics Physician. The organization holds a License No. 027036 (GA). The NPI Number for KIDS AVENUE PEDIATRICS LLC is 1801057609

Main info

Organization
Name
KIDS AVENUE PEDIATRICS LLC
NPI
1801057609
Phone
(770) 909-8007
Address
1720 PHOENIX BLVD
Authorized Official
PHYLLIS STEMBRIDGE PRACTICE MANAGER
Enumeration Date
24 June 2008
Last Update Date
24 June 2008
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness75
Years active:17State licenses:1Digital endpointsOther names

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Provider Addresses for KIDS AVENUE PEDIATRICS LLC

  • 1720, Phoenix Boulevard, Crystal Acres, College Park, Clayton County, Georgia, 30349, United States

    SUITE900

    COLLEGE PARK, GA 303495594

    Phone: (770) 909-8007

    Fax: (770) 909-8005

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30349)

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Reviews

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Frequently asked questions

How do payers reference KIDS AVENUE PEDIATRICS LLC?
For KIDS AVENUE PEDIATRICS LLC, use NPI 1801057609 as the unique 10-digit identifier.
Is KIDS AVENUE PEDIATRICS LLC shown as active in public data?
Registry records indicate KIDS AVENUE PEDIATRICS LLC maintains an active NPI.
What expertise is attributed to KIDS AVENUE PEDIATRICS LLC?
KIDS AVENUE PEDIATRICS LLC's specialty line reads Pediatrics Physician. Clinical services aligned with this taxonomy classification.
Where in Georgia is KIDS AVENUE PEDIATRICS LLC registered?
Use College Park, Georgia as the headline location for KIDS AVENUE PEDIATRICS LLC here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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