NPI age
18 years
Enumerated 2007-07-25
● Active Type 2 · Organization
Northside Children'S Pediatric Center, Llc
Northside Children'S Pediatric Center, Llc is 1 of 2726 pediatrics organizations in Georgia.
Primary specialty
Pediatrics
Plus 1 secondary
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Anderson
RN-Pnp, Member, And (spouse Of Md)
Last NPPES update
2012-01-24
Source: monthly bulk 2026-05
How this organization compares
Across 2726 active pediatrics providers in Georgia.
NPI age
18 years
≈ at median (18 yr)
Practice locations
1
0 secondary on file
Subspecialties
1
In the 23% of peers with subspecialties
NPI lifetime · 2007 → 2026
2007-07Enumerated in NPPES
2007
2026
Where they practice
Primary practice location
391 East Main Street, Historic Hawkins Building
Canton, GA 301142712
Mailing address
391 East Main Street, Historic Hawkins Building
Canton, GA 301142712
Authorized official
Stephanie Heaton Anderson, DNP, PNP, RNC
RN-Pnp, Member, And (spouse Of Md)
📞 7707206963
Individual providers at this organization
2 individual providers on file at this primary practice address.
- Michael Anderson, MD Pediatrics NPI 1073685418
- Stephanie Anderson, PNP, DNP, RNCS Nurse Practitioner NPI 1609087972
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...
-
Clinic/CenterDefinition to come...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 629697125A | |
| 01 (GA) | 1396945515 | AUTH REPRESENTATIVE: MICHAEL G. ANDERSON, MD, ENTITY ATTENDING PHYSICIAN |
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Northside Children's Pediatrics Center, PC
Practice context
Multi-provider organization. 2 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 →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.