The Center for Pediatric Excellence, PLLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

THE CENTER FOR PEDIATRIC EXCELLENCE, PLLC

Practice address

300 Stonecrest Blvd Ste 250
Smyrna, TN 37167-6832

Phone

(629) 220-0211

Fax

(629) 220-0210

NPI assigned

May 22, 2022

Last updated

Nov 30, 2023By 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

Dr. Derek Keith Johnson, MDNPI 1386603850

Title

Ceo

Phone

(615) 785-9303

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 4

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.

• Derek K. Johnson, M.D.

  • Pediatrics Physician
  • Smyrna, TN
  • NPI 1386603850
  Medicare reassignment NPD Authorized official
• Tara Lynn Fishwild, NP

  • Pediatric Nurse Practitioner
  • Smyrna, TN
  • NPI 1659093060

  Single Specialty

  Medicare reassignment NPD
• Marquita Leshawn Jones

  • Family Nurse Practitioner
  • Smyrna, TN
  • NPI 1710650171
  Medicare reassignment NPD
• Adaline Lawson

  • Student in an Organized Health Care Education/Training Program
  • Nashville, TN
  • NPI 1528957651
  NPD (past)

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

{
    "created_epoch": "1653177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701302400000",
    "number": "1386382273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 STONECREST BLVD STE 250",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371676832",
            "telephone_number": "629-220-0211",
            "fax_number": "629-220-0210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 STONECREST BLVD STE 250",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371676832",
            "telephone_number": "629-220-0211",
            "fax_number": "629-220-0210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CENTER FOR PEDIATRIC EXCELLENCE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-22",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "DEREK",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "615-785-9303",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresa G. Huggins, MD
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• Michelle Rae Terry, PHARM.D
• Mariah Lachelle Tharpe, MS,OTR/L
• The Dental Edge of Smyrna
• The Derek Johnson, M.D. Concussion Clinic
• The Family Way Homecare LLC
• The Optical Shoppe PLLC
• The Waters of Smyrna LLC

• Pediatrics Physician in Smyrna, TN
• Providers in Smyrna, TN by specialty
• Pediatrics Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.