Pediatrics Plus, PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PEDIATRICS PLUS, PLLC

Practice address

7215 S Siwell Rd Ste B
Byram, MS 39272-9776

Phone

(601) 201-4419

NPI assigned

Apr 16, 2024

Organization subpart

No

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

Authorized official

Name

Stephanie Oberhousen Boydston, NPNPI 1356984462

Title

Owner

Phone

(601) 201-4419

Specialties & licenses 1

Addresses

Other names 1

• Pediatrics Plus Medical Clinic Other name

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stephanie Oberhousen Boydston, FNP-C

  • Family Nurse Practitioner
  • Jackson, MS
  • NPI 1356984462
  Medicare reassignment NPD Authorized official
• Kayla Collum, FNP

  • Family Nurse Practitioner
  • Flowood, MS
  • NPI 1245091016
  Medicare reassignment NPD

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

{
    "created_epoch": "1713225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715904000000",
    "number": "1063266823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 RAYMOND BOLTON RD",
            "city": "RAYMOND",
            "state": "MS",
            "postal_code": "391549591",
            "telephone_number": "601-201-4419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7215 S SIWELL RD STE B",
            "city": "BYRAM",
            "state": "MS",
            "postal_code": "392729776",
            "telephone_number": "601-201-4419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRICS PLUS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-16",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A",
        "authorized_official_last_name": "BOYDSTON",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "OBERHOUSEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-201-4419",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatrics Plus Medical Clinic",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Pediatrics Plus Medical Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• McKimley Owens Hudson, M.ED., LDT, CALT
• Betsy Givens Pace, DPT
• Sharron Denise Paige, MPH, MS, RD, LD
• Twilah Paige
• Bhakti Patel, RPH
• Marie Pickens
• Polks Crossgates Discount Drugs Inc 6
• Prestige Dental Care
• Prestige Healthcare Medical
• Primary Family Medical Clinic

• Family Medicine Physician in Byram, MS
• Providers in Byram, MS by specialty
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.