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 is a Pediatrics Physician 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
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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