Pediatria Healthcare, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

05250501 Issued in PA

Legal business name

PEDIATRIA HEALTHCARE, LLC

Doing business as

Pediatria HealthCare for Kids

Practice address

1185 Jacks Run Rd
S.R. 48
North Versailles, PA 15137-2725

Phone

(412) 349-6712

Fax

(412) 349-6717

NPI assigned

Apr 25, 2013

Last updated

Mar 22, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Joseph D. Sansone

Title

Ceo, Chairman & Manager

Phone

(770) 840-1966

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pediatria HealthCare for Kids Doing business as

Locations

Practitioners 3

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.

• Stephanie Amdur-Clark, NP

  • Pediatric Nurse Practitioner
  • Rochester, NY
  • NPI 1851759872
  NPD (past)
• Michael Craig Butler, NP

  • Family Nurse Practitioner
  • Boston, MA
  • NPI 1275126914
  NPD (past)
• Kristin Grace Hanifin, CPNP-PC

  • Pediatric Nurse Practitioner
  • Boston, MA
  • NPI 1013589480
  NPD (past)

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

{
    "created_epoch": "1366848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458604800000",
    "number": "1134563711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5185 PEACHTREE PKWY",
            "address_2": "SUITE 350",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300926542",
            "telephone_number": "770-840-1966",
            "fax_number": "770-840-1901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1185 JACKS RUN RD",
            "address_2": "S.R. 48",
            "city": "NORTH VERSAILLES",
            "state": "PA",
            "postal_code": "151372725",
            "telephone_number": "412-349-6712",
            "fax_number": "412-349-6717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIA HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-25",
        "last_updated": "2016-03-22",
        "status": "A",
        "authorized_official_last_name": "SANSONE",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "CEO, CHAIRMAN & MANAGER",
        "authorized_official_telephone_number": "770-840-1966"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "PA",
            "license": "05250501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1021992800017",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatria HealthCare for Kids",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Terri Ann McCoy, RN
• Misty Dawn McMullen, NP-C
• Nia Nchami
• Ottonello Rheumatology LLC
• Viola Patsko
• Pediatria Healthcare, LLC (Aveanna Healthcare)
• Tamisha Phillips
• Premier Medical Associates, P.C. (Premier Medical Associates - North Versailles)
• Erica Ray
• Richard H. Katz M.D. LLC

• Home Health Agency in North Versailles, PA
• Providers in North Versailles, PA by specialty
• Home Health Agency in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2016; 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.