Pediatrust Columbus, LLC

Primary specialty

Pediatric Skilled Nursing FacilityTaxonomy code 3140N1450X

Legal business name

PEDIATRUST COLUMBUS, LLC

Practice address

2213 5TH St N
Columbus, MS 39705-2211

Phone

(662) 570-1957

Fax

(662) 470-1035

NPI assigned

May 17, 2017

Last updated

Oct 23, 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

Leann Craig

Title

Ceo

Phone

(225) 252-7633

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1494979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698019200000",
    "number": "1639606940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6700 JEFFERSON HIGHWAY, BUILDING 12, STE B",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "70806",
            "telephone_number": "225-665-6555",
            "fax_number": "225-665-6555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2213 5TH ST N",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397052211",
            "telephone_number": "662-570-1957",
            "fax_number": "662-470-1035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRUST COLUMBUS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-17",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A",
        "authorized_official_last_name": "CRAIG",
        "authorized_official_first_name": "LEANN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "225-252-7633"
    },
    "taxonomies": [
        {
            "code": "3140N1450X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Skilled Nursing Facility in Columbus, MS
• Providers in Columbus, MS by specialty
• Pediatric Skilled Nursing Facility in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; 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.