Pediatric Services of America, LLC

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

License

HC 0181 Issued in NC

Legal business name

PEDIATRIC SERVICES OF AMERICA, LLC

Doing business as

Aveanna Healthcare

Practice address

4530 Park Rd
Ste 105
Charlotte, NC 28209-3716

Phone

(704) 335-9797

Fax

(704) 335-9970

NPI assigned

Jun 29, 2006

Last updated

Jan 27, 2025By 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

Matthew Buckhalter

Title

Cfo

Phone

(470) 464-8000

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Aveanna Healthcare Doing business as

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

CLIA laboratory certificates

Tax ID family

Pediatric Services of76 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 4

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

• Pediatric Services of America, LLC

  dba Aveanna Healthcare

  • Nursing Care Agency
  • Raleigh, NC
  • NPI 1114955309
  NPD tax ID
• Pediatric Services of America, LLC

  dba Aveanna Healthcare

  • Nursing Care Agency
  • Fayetteville, NC
  • NPI 1174552665
  NPD tax ID
• Pediatric Services of America, LLC

  dba Aveanna Healthcare

  • Nursing Care Agency
  • Raleigh, NC
  • NPI 1962431577
  NPD tax ID
• Pediatric Services of America, LLC

  dba Aveanna Healthcare

  • Nursing Care Agency
  • Greenville, NC
  • NPI 1992729362
  NPD tax ID

Locations

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737936000000",
    "number": "1346278157",
    "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": "4530 PARK RD",
            "address_2": "STE 105",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093716",
            "telephone_number": "704-335-9797",
            "fax_number": "704-335-9970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC SERVICES OF AMERICA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-29",
        "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": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "NC",
            "license": "HC 0181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100144",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "EX0446",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3408666",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aveanna Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Nursing Care Agency in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Nursing Care Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.