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

Providence Pediatrics, LLC

Organization Primary Care Clinic/Center · NPI 1104086800

Providence Pediatrics, LLC is a Primary Care Clinic/Center in Tucker, Georgia. Licensed in Georgia. Registered with an NPI since 2008.

Licensed in
GA
In the registry since
2008
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

2171 Northlake Pkwy Ste 114
Tucker, GA 30084-4104
Phone: (770) 939-7477
Fax: (770) 939-7750
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Clinic/Center (primary) Taxonomy 261QP2300X · Licence 041796 (GA)

Record details

NPI number1104086800
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Erica Francis-Scott — Managing Member · (770) 939-7477
NPI enumeratedJune 16, 2008
Last updated in NPPESNovember 4, 2010
Mailing addressPo Box 870527, Stone Mountain, GA 30087-0014

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