NPIMap

Organization Active NPI

Children's International L.L.C.

  • Pediatrics Physician
  • Slidell, LA
National Provider Identifier
1073620498
Registry record updated Jul 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
CHILDREN'S INTERNATIONAL L.L.C.
Practice address
1430 Lindberg Dr
Slidell, LA 70458-8056
Phone
(985) 781-7337
Fax
(985) 781-7339
NPI assigned
Aug 23, 2006
Last updated
Jul 9, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2012

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

Authorized official

Name
Dr. Eduardo J. Hernandez, M.D.NPI 1508863002
Title
Owner/Medical Director
Phone
(985) 781-7337

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X Primary

Addresses

Primary practice location

1430 Lindberg Dr
Slidell, LA 70458-8056

Mailing address

1430 Lindberg Dr
Slidell, LA 70458-8056
Phone (985) 781-7337

Other identifiers 2

IdentifierTypeStateIssuer
09015381MedicaidMS
1449334MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, MS6 enrollments

Enrollment records 6

Enrollment IDStateProvider typePAC IDDetails
O20160106000472 LA Part A Provider - Rural Health Clinic 1254633308 Practice locations: Franklinton, LA
O20160106000849 LA Part A Provider - Rural Health Clinic 1254633308 Practice locations: Amite, LA
O20160114001669 MS Part A Provider - Rural Health Clinic 1254633308 Practice locations: Picayune, MS
O20161209000246 MS Part A Provider - Rural Health Clinic 1254633308 Practice locations: Morton, MS
O20230623000077 MS Part A Provider - Rural Health Clinic 1254633308 1 other NPI on this enrollment
Practice locations: Gautier, MS
O20250806000799 MS Part A Provider - Rural Health Clinic 1254633308 Practice locations: Wiggins, MS

NPI to CCN mapping 6

The Medicare certification numbers (CCNs) connected to NPI 1073620498. Details of each certification follow.

Rural health clinic certification: CCN 193918

Legal name
CHILDREN'S INTERNATIONAL, LLC
Doing business as
CHILDREN'S INTERNATIONAL MEDICAL GROUP
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 18, 2016
Last certification
Aug 18, 2025
Ownership / control type
1B
Organization structure
LLCProprietary
Incorporated
Apr 13, 1993 in LA
Enrollment address
2401 Washington St
Franklinton, LA 70438-2582

Rural health clinic certification: CCN 193919

Legal name
CHILDREN'S INTERNATIONAL, LLC
Doing business as
CHILDREN'S INTERNATIONAL MEDICAL GROUP
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Oct 25, 2016
Last certification
Oct 25, 2025
Ownership / control type
1B
Organization structure
LLCProprietary
Incorporated
Apr 13, 1993 in LA
Enrollment address
702 South First St
Amite, LA 70422-2136

Rural health clinic certification: CCN 253928

Legal name
CHILDREN'S INTERNATIONAL, LLC
Doing business as
CHILDREN'S INTERNATIONAL MEDICAL GROUP
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Feb 18, 2016
Last certification
Feb 18, 2016
Ownership / control type
1B
Organization structure
LLCProprietary
Incorporated
Apr 13, 1993 in LA
Enrollment address
801 Williams Ave
Picayune, MS 39466-3956

Rural health clinic certification: CCN 253930

Legal name
CHILDREN'S INTERNATIONAL, LLC
Doing business as
CHILDREN'S INTERNATIONAL MEDICAL GROUP
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 22, 2016
Last certification
Dec 22, 2016
Ownership / control type
1B
Organization structure
LLCProprietary
Incorporated
Apr 13, 1993 in LA
Enrollment address
3016 Highway 80
Morton, MS 39117-9393

Rural health clinic certification: CCN A53835

Legal name
CHILDREN'S INTERNATIONAL, LLC
Doing business as
CHILDREN'S INTERNATIONAL MEDICAL GROUP
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Nov 1, 2023
Last certification
Nov 1, 2023
Ownership / control type
1B
Organization structure
LLCProprietary
Incorporated
Apr 13, 1993 in LA
Enrollment address
341 US-90
Suite a
Gautier, MS 39553

Rural health clinic certification: CCN A53855

Legal name
CHILDREN'S INTERNATIONAL, LLC
Doing business as
CHILDREN'S INTERNATIONAL MEDICAL GROUP
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Nov 3, 2025
Last certification
Nov 3, 2025
Ownership / control type
1B
Organization structure
LLCProprietary
Enrollment address
930 Hall St
Suite a
Wiggins, MS 39577-2113

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

106 Mimosa St
Amite, LA 70422
Phone (985) 247-2411

618 Blue Meadow Rd
Bay St Louis, MS 39520
Phone (228) 467-1320

2561 Pass Rd
Biloxi, MS 39531
Phone (228) 400-0098

11240 Highway 49
Unit 300C
Gulfport, MS 39503
Phone (228) 831-8800

801 Williams Ave
Picayune, MS 39466
Phone (601) 798-5558

345 Buck Kirkland Rd
Poplarville, MS 39470
Phone (601) 746-4648

Ownership & related parties

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Children's International, LLC Organization, Slidell, LA LLC, Medical provider/supplier, For-profit Operational/Managerial Control Nov 27, 2013 100%
Eduardo J Hernandez Individual 5% Or Greater Direct Ownership Interest Jan 20, 2010 50%
Corporate OfficerChief Executive Office (Company) Nov 27, 2013 50%
Corporate DirectorChief Executive Officer (Company Nov 27, 2013 50%
Corporate OfficerChief Executive Officer (Company Nov 27, 2013 50%
Corporate OfficerManager of Living Trust Jan 20, 2010 50%
Corporate DirectorManager of Living Trust Jan 20, 2010 50%
W-2 Managing EmployeeSenior Vice President of Strateg Aug 12, 2009
5% Or Greater Indirect Ownership InterestCeo/Medical Director Jan 2, 2010 50%
Corporate Officer Jan 20, 2010 50%
Corporate Director Jan 20, 2010 50%
Lacey Shaw Individual W-2 Managing EmployeeChief Operating Officer Jul 6, 2010
Brittany Frost Individual W-2 Managing EmployeeChief Business Officer Aug 1, 2009
W-2 Managing EmployeeChief Business Officer Jan 1, 2010
The Living Trust of Eduardo and Heidi Hernandez Organization, Slidell, LA 5% Or Greater Direct Ownership Interest Sep 5, 2013 100%
Heidi B Hernandez Individual 5% Or Greater Indirect Ownership Interest Jan 20, 2010 50%
Corporate OfficerChief Business Officer (Company) Nov 27, 2013 50%
Corporate DirectorChief Business Officer (Company) Nov 27, 2013 50%
W-2 Managing EmployeeChief Nursing Officer Sep 21, 2009
Corporate OfficerManager of Living Trust Jan 20, 2010 50%
Corporate DirectorManager of Living Trust Jan 20, 2010 50%
W-2 Managing EmployeeSenior Vice President of Strateg Aug 12, 2009
Corporate OfficerLLC Manager Jan 20, 2010
Corporate DirectorLLC Manager Jan 20, 2010 50%
5% Or Greater Indirect Ownership InterestLLC Manager Jan 2, 2010 50%
The Living Trust of Eduardo and Heidi Hernadez Organization, Slidell, LA Medical provider/supplier 5% Or Greater Direct Ownership Interest May 1, 2025 100%

Owners & managing parties with NPI records 7

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 7

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 47

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.

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341792000000",
    "number": "1073620498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 LINDBERG DR",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704588056",
            "telephone_number": "985-781-7337",
            "fax_number": "985-781-7339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 LINDBERG DR",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704588056",
            "telephone_number": "985-781-7337",
            "fax_number": "985-781-7339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S INTERNATIONAL L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-23",
        "last_updated": "2012-07-09",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "EDUARDO",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "985-781-7337",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09015381",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1449334",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Slidell, LA

Sources for this page

Verify at the official NPI Registry.