Healthcare Provider Details

I. General information

NPI: 1861308256
Provider Name (Legal Business Name): ASCEND PEDIATRICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3964 ELNORA DR
MACON GA
31210-1825
US

IV. Provider business mailing address

3964 ELNORA DR
MACON GA
31210-1825
US

V. Phone/Fax

Practice location:
  • Phone: 478-309-1577
  • Fax: 478-309-1499
Mailing address:
  • Phone: 478-309-1577
  • Fax: 478-309-1499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: JASON SMITH
Title or Position: OWNER
Credential: MD
Phone: 478-309-1577