| Peds And Parents Family Care, Llc | |
|
124 Andrews Way Suite B Kingsland GA 31548-6860 | |
| (912) 729-7007 | |
| (912) 729-3627 |
| Full Name | Peds And Parents Family Care, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 124 Andrews Way, Kingsland, Georgia |
| Authorized Official Name and Position | Mary Lee Carter (PRESIDENT) |
| Authorized Official Contact | 9127297007 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peds And Parents Family Care, Llc 124 Andrews Way Suite B Kingsland GA 31548-6860 Ph: (912) 729-7007 | Peds And Parents Family Care, Llc 124 Andrews Way Suite B Kingsland GA 31548-6860 Ph: (912) 729-7007 |
| NPI Number | 1912115452 |
|---|---|
| Provider Enumeration Date | 05/18/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 0749697878 |
|---|---|
| Medicare Enrollment ID | O20210407001696 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912115452 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 54592 (Georgia) | Primary |
| Provider Name | Amir Wind |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174588420 PECOS PAC ID: 9234173089 Enrollment ID: I20100511000563 |
| Provider Name | Robert Davenport-ray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841223799 PECOS PAC ID: 8426225012 Enrollment ID: I20210407001881 |
| Provider Name | Virginia Knight |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770946048 PECOS PAC ID: 3971931494 Enrollment ID: I20210614000208 |
| Provider Name | Karin Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699362293 PECOS PAC ID: 3779955265 Enrollment ID: I20230209001726 |
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