Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1083876890 Individual Practitioner Male Practitioner

Dr. Nicholas Kelly , MD

Pediatrics • Canton, GA

Professional Overview & Biography Verified Profile Summary

Dr. Nicholas Kelly, MD is a registered healthcare professional specializing in Pediatrics in Canton, GA. Practice services are available at 1558 RIVERSTONE PKWY STE 100 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1558 Riverstone Pkwy Ste 100

Canton, GA 301142888

Telephone 4047855437
Fax 4047854683
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Canton, GA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 21.2 Yrs
Regional Practice Density
15 Specialists

Practicing in Canton, GA (2326 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License GA 73648

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Andrea Center , CPNP

Nurse Practitioner - Pediatrics, Critical Care

NPI 1003244013

Certified Pediatric Nurse Practitioner

Dr. Jacob Humphrey , MD

Pediatrics - Pediatric Nephrology

NPI 1003340472

Doctor of Medicine (M.D.)

Dr. Ashwini Tilak , MD

Otolaryngology - Pediatric Otolaryngology

NPI 1003379595

Doctor of Medicine (M.D.)

Anh Trieu , PA-C

Physician Assistant

NPI 1003479361

Physician Assistant (Certified)

Dr. Tripti Brar , MBBS, MS

Student in an Organized Health Care Education/Training Program

NPI 1003501495

Bachelor of Medicine, Bachelor of Surgery (M.B.B.S.), Master of Science

Dr. Arlene Stecenko , MD

Internal Medicine - Pulmonary Disease

NPI 1003863564

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events
📍
Updated Practice Location June 25, 2021

Registered at 1558 RIVERSTONE PKWY STE 100, CANTON, GA 301142888 (Tel: 4047855437)

📍
Updated Business Mailing Address June 25, 2021

Registered at 1558 RIVERSTONE PKWY STE 100, CANTON, GA 301142888 (Tel: 4047855437)

👤
Provider Name / Credentials Updated June 25, 2021

Recorded as NICHOLAS KELLY, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 25, 2021

Pediatrics (License #73648 in GA)

NPI Profile Active November 08, 2013

NPI status registered as active in NPPES database

📍
Updated Practice Location November 08, 2013

Registered at 4331 HIGHWAY 39 N, MERIDIAN, MS 393011007 (Tel: 6014846180)

📍
Updated Business Mailing Address November 08, 2013

Registered at 1314 19TH AVE, MERIDIAN, MS 393014116 (Tel: 6017034282)

👤
Provider Name / Credentials Updated November 08, 2013

Recorded as NICHOLAS KELLY, MD.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 08, 2013

Pediatrics (License #22179 in MS)

🟢
Initial NPI Registration & Enumeration July 02, 2008

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1083876890
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 02, 2008
Last Update: June 06, 2022
Sole Proprietor: No

Mailing Address

1558 Riverstone Pkwy Ste 100

Canton, GA 301142888

Phone: 4047855437

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.