NPIMap

Organization Active NPI

Csi-Pediatric Services, LLC.

Doing business as CSI Special Care

  • Health Service Clinic/Center
  • Jacksonville, FL
National Provider Identifier
1407277171
Registry record updated Jul 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
60081003 Issued in FL
Legal business name
CSI-PEDIATRIC SERVICES, LLC.
Doing business as
CSI Special Care
Practice address
10750 Atlantic Blvd
Suite 11
Jacksonville, FL 32225-2946
Phone
(904) 380-0419
Fax
(904) 564-3716
NPI assigned
Dec 26, 2013
Last updated
Jul 13, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
PEDIATRIC HOLDINGS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 13, 2022

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

Authorized official

Name
Donna Lodato, RN
Title
Ceo
Phone
(786) 522-9600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X 60081003 FL Primary

Addresses

Primary practice location

10750 Atlantic Blvd
Suite 11
Jacksonville, FL 32225-2946

Mailing address

15050 NW 79TH CT Ste 201
Miami Lakes, FL 33016-5810
Phone (786) 522-9600

Other identifiers 1

IdentifierTypeStateIssuer
024118800MedicaidFL

Other names 2

  • CSI Special Care Doing business as
  • Spark Pediatrics Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address donnal@sparkpediatrics.com

National Provider Directory

National Provider Directory
Tax ID family
Csi Special Care15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations

10750 Atlantic Blvd
Ste 11
Jacksonville, FL 32225
Phone (786) 522-9600

Practitioners & affiliated clinicians

Practitioners 1

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": "1388016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657670400000",
    "number": "1407277171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15050 NW 79TH CT STE 201",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330165810",
            "telephone_number": "786-522-9600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10750 ATLANTIC BLVD",
            "address_2": "SUITE 11",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322252946",
            "telephone_number": "904-380-0419",
            "fax_number": "904-564-3716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CSI-PEDIATRIC SERVICES, LLC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PEDIATRIC HOLDINGS, LLC",
        "enumeration_date": "2013-12-26",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A",
        "authorized_official_last_name": "LODATO",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "786-522-9600",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "FL",
            "license": "60081003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024118800",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "donnal@sparkpediatrics.com",
            "affiliation": "N",
            "address_1": "10750 Atlantic Blvd",
            "address_2": "Suite 11",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322252946",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "CSI Special Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CSI Special Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Spark Pediatrics",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Jul 13, 2022; 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.