OrganizationActive
Providence Pediatrics, LLC
NPI 1104086800 · Primary Care Clinic/Center · Tucker, GA
Provider details
- NPI number
- 1104086800
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Erica Francis-Scott, Managing Member(770) 939-7477
- License
- 041796 (GA)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(87/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2171 Northlake Pkwy
Suite 114
Tucker, GA 30084-4104
Phone: (770) 939-7477
Fax: (770) 939-7750
Street-level locationGet directions
Mailing address
Po Box 870527
Stone Mountain, GA 30087-0014
Registry dates
- Enumerated
- 2008-06-16
- Last updated
- 2010-11-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.