NPI age
13 years
Enumerated 2012-07-26
● Active Type 2 · Organization
Performance Pediatrics And Sports Medicine, Llc
Performance Pediatrics And Sports Medicine, Llc is 1 of 18 pediatrics organizations in Georgia.
Primary specialty
Pediatrics
Plus 2 secondary
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Merritt
Owner Physician
Last NPPES update
2012-07-26
Source: monthly bulk 2026-05
How this organization compares
Across 18 active pediatrics providers in Georgia.
NPI age
13 years
↓ 4 yr below median
Practice locations
1
0 secondary on file
Subspecialties
2
In the 55% of peers with subspecialties
NPI lifetime · 2012 → 2026
2012-07Enumerated in NPPES
2012
2026
Where they practice
Primary practice location
1181 Langford Dr, Bldg 200-101
Bogart, GA 306222542
Mailing address
1181 Langford Dr, Bldg 200-101
Bogart, GA 306222542
Authorized official
Tara Ann Merritt, M.D.
Owner Physician
📞 7062023236
Individual providers at this organization
3 individual providers on file at this primary practice address.
- John Dobberstein, DMD Dentist NPI 1194885061
- Kevin Oneal, MD Family Medicine NPI 1740218072
- Vandana Setia, MD Family Medicine NPI 1114958675
Specialties
-
Pediatrics PrimaryA pediatrician who is responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have...
-
Internal MedicineA physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer,...
-
PediatricsA 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...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 58543 | STATE MEDICAL LICENSE |
| 05 (GA) | 003125239A | |
| 05 (GA) | 489449582C |
Practice context
Multi-provider organization. 3 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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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.