Pediatric Place, LLC

Primary specialty

Medically Fragile Infants and Children Day CareTaxonomy code 261QM3000X

Legal business name

PEDIATRIC PLACE, LLC

Practice address

116 Marketridge Dr
Ridgeland, MS 39157-6009

Phone

(601) 613-4254

NPI assigned

May 30, 2023

Last updated

May 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

Carmen M Young

Title

Executive Director

Phone

(601) 613-4254

Specialties & licenses 1

Addresses

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

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

{
    "created_epoch": "1685404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685404800000",
    "number": "1750074415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 MARKETRIDGE DR",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391576009",
            "telephone_number": "601-613-4254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 MARKETRIDGE DR",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391576009",
            "telephone_number": "601-613-4254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC PLACE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-30",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "601-613-4254"
    },
    "taxonomies": [
        {
            "code": "261QM3000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medically Fragile Infants and Children Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sonya Pawloski, S.L.P.
• William David Payne, M.D.
• Abigail Rose Peavey
• Niketa C Pechan, LCSW
• Pediatric Dentistry of Ridgeland, PLLC
• Walker Nelson Pedigo, DDS
• Catherine Ranck Perez
• Performance Rehab, Inc
• Johnny Julian Perkins Jr., PTA
• Sherry L Perkins, LPTA

• Medically Fragile Infants and Children Day Care in Ridgeland, MS
• Providers in Ridgeland, MS by specialty
• Medically Fragile Infants and Children Day Care in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.