NPIMap

Organization Active NPI

Pediatric Services of America, LLC

Doing business as Aveanna Healthcare

  • Nursing Care Agency
  • Pensacola, FL
National Provider Identifier
1659391944
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Care AgencyTaxonomy code 251J00000X
License
HHA21913096 Issued in FL
Legal business name
PEDIATRIC SERVICES OF AMERICA, LLC
Doing business as
Aveanna Healthcare
Practice address
2114 Airport Blvd Ste 2000
Pensacola, FL 32504-5911
Phone
(850) 444-4365
Fax
(850) 444-4393
NPI assigned
Jul 20, 2006
Last updated
Jan 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU
Nursing Care Agency 251J00000X HHA21913096 FL Primary

Addresses

Primary practice location

2114 Airport Blvd Ste 2000
Pensacola, FL 32504-5911

Mailing address

400 Interstate North Pkwy SE Ste 1600
Atlanta, GA 30339-5047
Phone (470) 464-8000

Other identifiers 2

IdentifierTypeStateIssuer
650574100MedicaidFL
650448596MedicaidFL

Other names 1

  • Aveanna Healthcare Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pediatric Services of76 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 20

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

View all 20

Locations

2065 Airport Blvd
Ste 400
Pensacola, FL 32504

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737936000000",
    "number": "1659391944",
    "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": "2114 AIRPORT BLVD STE 2000",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325045911",
            "telephone_number": "850-444-4365",
            "fax_number": "850-444-4393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC SERVICES OF AMERICA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "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": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "FL",
            "license": "HHA21913096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "650574100",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "650448596",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aveanna Healthcare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Aveanna Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pensacola, FL

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.