NPIMap

Organization Active NPI

Pediatric Services of America, LLC

Doing business as Aveanna Healthcare

  • Nursing Care Agency
  • Jacksonville, FL
National Provider Identifier
1144984931
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Care AgencyTaxonomy code 251J00000X
Legal business name
PEDIATRIC SERVICES OF AMERICA, LLC
Doing business as
Aveanna Healthcare
Practice address
8659 Baypine Road, Ste 100
Building 3
Jacksonville, FL 32256
Phone
(904) 730-2200
NPI assigned
Oct 27, 2021
Last updated
Oct 27, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2021

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

Authorized official

Name
Vicki Whiteside
Title
Avp
Phone
(470) 464-8000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X NU Primary

Addresses

Primary practice location

8659 Baypine Road, Ste 100
Building 3
Jacksonville, FL 32256

Mailing address

400 Interstate North Pkwy SE Ste 1600
Atlanta, GA 30339-5047

Other identifiers 1

IdentifierTypeStateIssuer
678778965MedicaidFL

Other names 1

  • Aveanna Healthcare Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pediatric Services of76 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 14

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 14

Locations

8659 Baypine Rd
Ste 100
Jacksonville, FL 32256
Phone (904) 730-2200

NPI Registry JSON

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

{
    "created_epoch": "1635292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635292800000",
    "number": "1144984931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 INTERSTATE NORTH PKWY SE STE 1600",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303395047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8659 BAYPINE ROAD, STE 100",
            "address_2": "BUILDING 3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32256",
            "telephone_number": "904-730-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC SERVICES OF AMERICA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-27",
        "last_updated": "2021-10-27",
        "certification_date": "2021-09-24",
        "status": "A",
        "authorized_official_last_name": "WHITESIDE",
        "authorized_official_first_name": "VICKI",
        "authorized_official_title_or_position": "AVP",
        "authorized_official_telephone_number": "470-464-8000"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "678778965",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aveanna Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.