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

Kaleidoscope Pediatrics PC

Organization Pediatric Adolescent Medicine Physician · NPI 1407045495

Kaleidoscope Pediatrics PC is a Pediatric Adolescent Medicine Physician in Marietta, Georgia. Registered with an NPI since 2007.

In the registry since
2007
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1523 Johnson Ferry Rd Ste 150
Marietta, GA 30062-6438
Phone: (770) 509-1234
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Adolescent Medicine Physician (primary) Taxonomy 2080A0000X

Record details

NPI number1407045495
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Susan Staviss — President · (770) 509-1234
NPI enumeratedOctober 16, 2007
Last updated in NPPESOctober 16, 2007
Mailing address1523 Johnson Ferry Rd, Suite 150, Marietta, GA 30062-6438

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