NPIMap

Organization Active NPI

Pediatric Services of America, LLC

Doing business as Aveanna Healthcare

  • Nursing Care Agency
  • Peachtree Corners, GA
National Provider Identifier
1326070673
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Care AgencyTaxonomy code 251J00000X
License
060-251-H Issued in GA
Legal business name
PEDIATRIC SERVICES OF AMERICA, LLC
Doing business as
Aveanna Healthcare
Practice address
6525 The Corners Pkwy Ste 305
Peachtree Corners, GA 30092-3351
Phone
(770) 263-6373
Fax
(770) 441-1317
NPI assigned
Jul 7, 2006
Last updated
Jan 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Authorized official

Name
Matthew Buckhalter
Title
Cfo
Phone
(470) 464-8000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 067-R-0003 GA
Nursing Care Agency 251J00000X 060-251-H GA Primary

Addresses

Primary practice location

6525 The Corners Pkwy Ste 305
Peachtree Corners, GA 30092-3351

Mailing address

400 Interstate North Pkwy SE Ste 1600
Atlanta, GA 30339-5047
Phone (470) 464-8000

Other identifiers 2

IdentifierTypeStateIssuer
00859548AMedicaidGA
538807248AMedicaidGA

Other names 1

  • Aveanna Healthcare Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070905000080 GA Part A Provider - Home Health Agency 5991614760 Practice locations: Peachtree Corners, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1326070673. Details of each certification follow.

Home health agency certification: CCN 117128

Legal name
PEDIATRIC SERVICES OF AMERICA, LLC
Doing business as
AVEANNA HEALTHCARE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Feb 18, 2000
Last certification
Sep 6, 2016
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Dec 28, 2020 in GA
Enrollment address
6075 The Corners Pkwy
Ste 120
Peachtree Corners, GA 30092-3329

Other NPIs with the same Medicare PAC ID 19

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

View all 19

Care Compare: Home health agency

Medicare Care Compare
Listed as
Aveanna HealthcareCCN 117128 · All quality measures
Ownership
Proprietary
Certified
Feb 18, 2000
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Physical therapy

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D0986061Pediatric Services of America LLC6525 The Corners Parkway, Suite 305, Peachtree Corners, GA 30092Certificate of waiverMay 6, 2027

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 9

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

Locations

6525 The Corners Pkwy
Ste 305
Peachtree Corners, GA 30092
Phone (770) 263-6373

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
J.H. Whitney VII LP Organization, New Canaan, CT For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 16, 2017 16.67%
Psa Healthcare Investment Holding LLC Organization, New Canaan, CT LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 16, 2017 8.33%
Aveanna Healthcare LLC Organization, Atlanta, GA Created for acquisition, LLC, For-profit, Chain home office, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 16, 2017 100%
Aveanna Healthcare Intermediate Holdings LLC Organization, Atlanta, GA Created for acquisition, LLC, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 16, 2017 100%
Pediatric Services Holding LLC Organization, Atlanta, GA LLC, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Dec 30, 2020 100%
Aveanna Healthcare Holdings Inc Organization, Atlanta, GA Created for acquisition, Corporation, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 16, 2017 100%
Matthew Buckhalter Individual Corporate OfficerCfo Jul 7, 2023
Corporate DirectorCfo Jul 7, 2023
Bcip Associates IV US L.P. Organization, Boston, MA For-profit, Private equity company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 16, 2017 5.53%
Hamilton Lane Co-Investment Fund III Holdings - 2 LP Organization, Bala Cynwyd, PA For-profit, Private equity company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 19, 2015 7.76%
Deborah Stewart Individual Corporate DirectorDirector Jul 7, 2023
Bain Capital Fund XI LP Organization, Boston, MA For-profit, Private equity company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 16, 2017 36.71%
Psa Healthcare Intermediate Holding LLC Organization, Atlanta, GA LLC, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Dec 30, 2020 100%
Shannon L Drake Individual Corporate OfficerSecretary Jun 8, 2021
Pediatric Services of America LLC Organization, Atlanta, GA LLC, Holding company, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Aug 31, 2007 100%
Devin Letzer Individual W-2 Managing Employee Mar 8, 2022
Bcpe Eagle Investor, L.P. Organization, Boston, MA Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 29, 2021 43.21%
Jeffrey Shaner Individual Corporate OfficerCeo Dec 1, 2015
Corporate DirectorCeo Jan 1, 2023
Pea Washington Holdings, LP Organization, George Town For-profit, Private equity company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 29, 2021 5.65%

All facility ownership & control disclosures 7

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Aveanna HealthcareEnglewood, CO, CCN 067192 Home health agency 5% Or Greater Indirect Ownership Interest (100%) Sep 17, 2016
Thrive Skilled Pediatric CareScottsdale, AZ, CCN 037286 Home health agency 5% Or Greater Indirect Ownership Interest (100%) Jun 2, 2025
Aveanna HealthcareErie, PA, CCN 397310 Home health agency 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2016
Aveanna HealthcareLoveland, CO, CCN 067477 Home health agency 5% Or Greater Direct Ownership Interest (100%) Sep 26, 2020
Aveanna HealthcareWexford, PA, CCN 397278 Home health agency 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2016
Aveanna HealthcareWestminster, CO, CCN 067496 Home health agency 5% Or Greater Direct Ownership Interest (100%) Sep 26, 2020
Aveanna HealthcareDu Bois, PA, CCN 398190 Home health agency 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2016

Owned or controlled facilities with NPI records 7

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 122

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

  • Five Points Healthcare of Ga LLC

    dba Aveanna Home Health

    • Home Health Agency
    • Smyrna, GA
    • NPI 1245877950

    Aveanna Healthcare Holdings Inc, Aveanna Healthcare Intermediate Holdings LLC, Aveanna Healthcare LLC, Bain Capital Fund XI LP, Bcip Associates IV US L.P., Bcpe Eagle Investor, L.P., Hamilton Lane Co-Investment Fund III Holdings - 2 LP, J.H. Whitne

    CMS ownership
  • Five Points Healthcare of Ga LLC

    dba Aveanna Hospice

    • Community Based Hospice Care Agency
    • Duluth, GA
    • NPI 1275103509

    Aveanna Healthcare Holdings Inc, Aveanna Healthcare Intermediate Holdings LLC, Aveanna Healthcare LLC, Bain Capital Fund XI LP, Bcip Associates IV US L.P., Bcpe Eagle Investor, L.P., Hamilton Lane Co-Investment Fund III Holdings - 2 LP, J.H. Whitne

    CMS ownership
  • Five Points Healthcare of Ga LLC

    dba Aveanna Home Health

    • Home Health Agency
    • Duluth, GA
    • NPI 1821635533

    Aveanna Healthcare Holdings Inc, Aveanna Healthcare Intermediate Holdings LLC, Bain Capital Fund XI LP, Bcip Associates IV US L.P., Bcpe Eagle Investor, L.P., Hamilton Lane Co-Investment Fund III Holdings - 2 LP, J.H. Whitney VII LP, Pea Washington

    CMS ownership
  • Five Points Healthcare of Ga, LLC

    dba Aveanna Home Health

    • Home Health Agency
    • Pooler, GA
    • NPI 1922715127

    Aveanna Healthcare Holdings Inc, Aveanna Healthcare Intermediate Holdings LLC, Aveanna Healthcare LLC, Bain Capital Fund XI LP, Bcip Associates IV US L.P., Bcpe Eagle Investor, L.P., Hamilton Lane Co-Investment Fund III Holdings - 2 LP, J.H. Whitne

    CMS ownership
  • Pediatric Services of America, LLC

    dba Aveanna Healthcare

    • Nursing Care Agency
    • Macon, GA
    • NPI 1093746430

    Aveanna Healthcare Holdings Inc, Aveanna Healthcare Intermediate Holdings LLC, Aveanna Healthcare LLC, Bain Capital Fund XI LP, Bcip Associates IV US L.P., Bcpe Eagle Investor, L.P., Hamilton Lane Co-Investment Fund III Holdings - 2 LP, J.H. Whitne

    CMS ownership
  • Pediatric Services of America, LLC

    dba Aveanna Healthcare

    • Nursing Care Agency
    • Martinez, GA
    • NPI 1538191820

    Aveanna Healthcare Holdings Inc, Aveanna Healthcare Intermediate Holdings LLC, Aveanna Healthcare LLC, Bain Capital Fund XI LP, Bcip Associates IV US L.P., Bcpe Eagle Investor, L.P., Hamilton Lane Co-Investment Fund III Holdings - 2 LP, J.H. Whitne

    CMS ownership
  • Shepherdcare Hospice,LLC

    dba Aveanna Hospice

    • Community Based Hospice Care Agency
    • Stockbridge, GA
    • NPI 1932459328

    Aveanna Healthcare Holdings Inc, Aveanna Healthcare Intermediate Holdings LLC, Aveanna Healthcare LLC, Bain Capital Fund XI LP, Bcip Associates IV US L.P., Bcpe Eagle Investor, L.P., Hamilton Lane Co-Investment Fund III Holdings - 2 LP, J.H. Whitne

    CMS ownership
  • 5 Star Home Health Services, LLC

    dba Aveanna Home Health

    • Home Health Agency
    • Orlando, FL
    • NPI 1376584730

    Aveanna Healthcare Holdings Inc, Aveanna Healthcare Intermediate Holdings LLC, Aveanna Healthcare LLC, Bain Capital Fund XI LP, Bcip Associates IV US L.P., Bcpe Eagle Investor, L.P., Hamilton Lane Co-Investment Fund III Holdings - 2 LP, J.H. Whitne

    CMS ownership
  • 5 Star Home Health Services, LLC

    dba Aveanna Home Health

    • Home Health Agency
    • Gainesville, FL
    • NPI 1518182773

    Aveanna Healthcare Holdings Inc, Aveanna Healthcare Intermediate Holdings LLC, Aveanna Healthcare LLC, Bain Capital Fund XI LP, Bcip Associates IV US L.P., Bcpe Eagle Investor, L.P., Hamilton Lane Co-Investment Fund III Holdings - 2 LP, J.H. Whitne

    CMS ownership
  • Andventure, LLC

    dba Aveanna Healthcare

    • Home Health Agency
    • Chambersburg, PA
    • NPI 1013150275

    Aveanna Healthcare Holdings Inc, Aveanna Healthcare Intermediate Holdings LLC, Aveanna Healthcare LLC, Bain Capital Fund XI LP, Bcip Associates IV US L.P., Bcpe Eagle Investor, L.P., Hamilton Lane Co-Investment Fund III Holdings - 2 LP, J.H. Whitne

    CMS ownership
  • Andventure, LLC

    dba Aveanna Healthcare

    • Home Health Agency
    • Phoenix, AZ
    • NPI 1013156470

    Aveanna Healthcare Holdings Inc, Aveanna Healthcare Intermediate Holdings LLC, Aveanna Healthcare LLC, Bain Capital Fund XI LP, Bcip Associates IV US L.P., Bcpe Eagle Investor, L.P., Hamilton Lane Co-Investment Fund III Holdings - 2 LP, J.H. Whitne

    CMS ownership
  • Andventure, LLC

    dba Aveanna Healthcare

    • Home Health Agency
    • Lancaster, PA
    • NPI 1093788002

    Aveanna Healthcare Holdings Inc, Aveanna Healthcare Intermediate Holdings LLC, Aveanna Healthcare LLC, Bain Capital Fund XI LP, Bcip Associates IV US L.P., Bcpe Eagle Investor, L.P., Hamilton Lane Co-Investment Fund III Holdings - 2 LP, J.H. Whitne

    CMS ownership
View all 122

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737936000000",
    "number": "1326070673",
    "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",
            "telephone_number": "470-464-8000",
            "fax_number": "770-248-8192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6525 THE CORNERS PKWY STE 305",
            "city": "PEACHTREE CORNERS",
            "state": "GA",
            "postal_code": "300923351",
            "telephone_number": "770-263-6373",
            "fax_number": "770-441-1317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC SERVICES OF AMERICA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A",
        "authorized_official_last_name": "BUCKHALTER",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "470-464-8000"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "GA",
            "license": "067-R-0003",
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "GA",
            "license": "060-251-H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00859548A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "538807248A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aveanna Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Peachtree Corners, GA

Sources for this page

Verify at the official NPI Registry.