NPIMap

Organization Active NPI

Pediatrics Reimagined LLC

Doing business as Your Local Pediatrics on Demand

  • Urgent Care Clinic/Center
  • Mandeville, LA
National Provider Identifier
1356123350
Registry record updated Oct 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
PEDIATRICS REIMAGINED LLC
Doing business as
Your Local Pediatrics on Demand
Practice address
1901 Highway 190 Ste 9
Mandeville, LA 70448-3495
Phone
(985) 231-4060
Fax
(985) 353-4460
NPI assigned
Oct 16, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2025

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

Authorized official

Name
Michelle Theard, DNP, CPNP-ACNPI 1841848009
Title
Managing Member
Phone
(504) 343-4714

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

1901 Highway 190 Ste 9
Mandeville, LA 70448-3495

Mailing address

1901 Highway 190 Ste 9
Mandeville, LA 70448-3495
Phone (985) 231-4060

Other identifiers 1

IdentifierTypeStateIssuer
2652290MedicaidLA

Other names 1

  • Your Local Pediatrics on Demand Doing business as

National Provider Directory

National Provider Directory

Locations

1901 Highway 190
Ste 9
Mandeville, LA 70448
Phone (985) 231-4060

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1697414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761868800000",
    "number": "1356123350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 HIGHWAY 190 STE 9",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704483495",
            "telephone_number": "985-231-4060",
            "fax_number": "985-353-4460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 HIGHWAY 190 STE 9",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704483495",
            "telephone_number": "985-231-4060",
            "fax_number": "985-353-4460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRICS REIMAGINED LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-16",
        "last_updated": "2025-10-31",
        "certification_date": "2025-10-31",
        "status": "A",
        "authorized_official_last_name": "THEARD",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "504-343-4714",
        "authorized_official_credential": "DNP, CPNP-AC"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2652290",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Your Local Pediatrics on Demand",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mandeville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2025; 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.