Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Northside Children's Pediatric Center, LLC

Organization Pediatrics Physician · NPI 1396945515

Northside Children's Pediatric Center, LLC provides Pediatrics Physician services in Canton, Georgia. Licensed in Georgia. Registered with an NPI since 2007.

Licensed in
GA
In the registry since
2007
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

391 E Main Street Historic Hawkins Bldg
Canton, GA 30114-2712 Not confirmed with CMS for 14 years — call before visiting
Phone: (770) 720-6963
Fax: (770) 720-6965
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence GA 54532 (GA)
Primary Care Clinic/Center Taxonomy 261QP2300X · Licence GA PHYSICIAN 54532 (GA)

Record details

NPI number1396945515
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Stephanie Anderson — Rn-Pnp, Member, And (Spouse Of Md) · (770) 720-6963
Other names Northside Children'S Pediatrics Center, Pc
NPI enumeratedJuly 25, 2007
Last updated in NPPESJanuary 24, 2012
Mailing address391 East Main Street, Historic Hawkins Building, Canton, GA 30114-2712

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