NPIMap

Organization Active NPI

Little Pine Pediatrics PLLC

  • General Practice Physician
  • Alachua, FL
National Provider Identifier
1053084913
Registry record updated Oct 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
LITTLE PINE PEDIATRICS PLLC
Practice address
15551 NW US Highway 441 Unit 40
Alachua, FL 32615-9330
Phone
(386) 518-0102
NPI assigned
Jul 27, 2021
Last updated
Oct 6, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kimberly Stroud
Title
Practice Manager
Phone
(855) 577-5437

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X Primary

Addresses

Primary practice location

15551 NW US Highway 441 Unit 40
Alachua, FL 32615-9330

Mailing address

1702 S Jefferson St
Perry, FL 32348-5611
Phone (855) 577-5437

Other identifiers 1

IdentifierTypeStateIssuer
001165806MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Little Pine Pediatrics PLLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

15551 NW US Highway 441
Unit 40
Alachua, FL 32615
Phone (386) 518-0102

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1627344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633478400000",
    "number": "1053084913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 S JEFFERSON ST",
            "city": "PERRY",
            "state": "FL",
            "postal_code": "323485611",
            "telephone_number": "855-577-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15551 NW US HIGHWAY 441 UNIT 40",
            "city": "ALACHUA",
            "state": "FL",
            "postal_code": "326159330",
            "telephone_number": "386-518-0102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLE PINE PEDIATRICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-27",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A",
        "authorized_official_last_name": "STROUD",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "855-577-5437"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001165806",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alachua, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.