NPI age
20 years
Enumerated 2005-08-16
● Active Type 2 · Organization
Southern Crescent Pediatrics Pc
Southern Crescent Pediatrics Pc 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
Sherwood
President
Last NPPES update
2020-08-22
Source: monthly bulk 2026-05
How this organization compares
Across 2726 active pediatrics providers in Georgia.
NPI age
20 years
↑ 2 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2005 → 2026
2005-08Enumerated in NPPES
2005
2026
Where they practice
Primary practice location
6584 Professional Pl, Ste C
Riverdale, GA 302744942
Mailing address
150 Medical Blvd, Ste B
Stockbridge, GA 302815053
Authorized official
Juan Jose Sherwood, MD
President
📞 7703899944
Individual providers at this organization
1 individual provider on file at this primary practice address.
- Dashawn Bakari, M.D. Physical Medicine & Rehabilitation NPI 1184801276
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...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 | 7802 | KAISER POS |
| 01 | 0526682 | AETNA SELECT US HEALTHC |
| 01 | 7802 | KAISER |
| 01 | 1202577 | UNITED HEALTHCARE |
| 01 | 276714 | BCBS |
| 01 | S06119 | SC HEALTHSOURCE |
Practice context
Multi-provider organization. 1 individual provider on file at this primary address.
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