STAY WELL PEDIATRICS LLC NPI 1669756292

NPI Information

  • NPI: 1669756292
  • Provider Name: STAY WELL PEDIATRICS LLC
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • CLIA Number: 11D2006606
  • Address: 5139 JIMMY CARTER BLVD
    SUITE # 205
    NORCROSS, GA
    ZIP 30093
  • Phone: (678) 248-2350

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NPI Details

STAY WELL PEDIATRICS LLC is a primary care clinic center in Norcross, GA. STAY WELL PEDIATRICS LLC NPI is 1669756292. The provider is registered as an organization entity type.

The provider's business location address is:

5139 JIMMY CARTER BLVD
SUITE # 205
NORCROSS, GA
ZIP 30093-680
Phone: (678) 248-2350
Fax: (678) 404-8435

The provider's authorized official is Neha Soni .
The authorized official title is Owner and has the following contact phone number (678) 248-2350.

The CLIA number assigned to this NPI record is 11D2006606 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/30/2011 and was last updated on 9/30/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QP2300XClinic/CenterPrimary Care060096GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1328093387AMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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