NPI age
19 years
Enumerated 2006-11-09
● Active Type 2 · Organization
Locust Grove Pediatrics
Locust Grove Pediatrics is 1 of 2726 pediatrics organizations in Georgia.
Primary specialty
Pediatrics
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Mynatt
Owner
Last NPPES update
2007-09-10
Source: monthly bulk 2026-05
How this organization compares
Across 2726 active pediatrics providers in Georgia.
NPI age
19 years
≈ at median (18 yr)
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2006 → 2026
2006-11Enumerated in NPPES
2006
2026
Where they practice
Primary practice location
5040 Bill Gardner Pkwy, Suite 100
Locust Grove, GA 302483645
Mailing address
5040 Bill Gardner Pkwy, Suite 100
Locust Grove, GA 302483645
Authorized official
John Mynatt, MD
Owner
📞 6785835437
Individual providers at this organization
4 individual providers on file at this primary practice address.
- Tammy Green, CPNP Nurse Practitioner NPI 1609234129
- Charmille Hare, DO Family Medicine NPI 1114140704
- John Mynatt, MD Pediatrics NPI 1629037528
- Whitney Williams, CPNP Nurse Practitioner NPI 1902144637
Specialties
-
Pediatrics PrimaryA 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...
Practice context
Multi-provider organization. 4 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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