NPIMap

Organization Active NPI

Kidzcare Pediatrics, PC

  • Pediatrics Physician
  • Wilmington, NC
National Provider Identifier
1760865760
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
118386 Issued in NC
Legal business name
KIDZCARE PEDIATRICS, PC
Practice address
1606 Wellington Ave Ste F
Wilmington, NC 28401-7704
Phone
(910) 392-5634
Fax
(910) 392-5654
NPI assigned
Jul 8, 2015
Last updated
Oct 14, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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

Authorized official

Name
Shantae Renee Lockhart
Title
Credentialing Coordinator
Phone
(910) 483-7337

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X 118386 NC Primary

Addresses

Primary practice location

1606 Wellington Ave Ste F
Wilmington, NC 28401-7704

Mailing address

PO Box 9219
Fayetteville, NC 28311-9082
Phone (910) 483-7337

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2098673Kidzcare Pediatrics, PC1606 Wellington Drive, Suite F, Wilmington, NC 28401Certificate of waiverJul 12, 2027

National Provider Directory

National Provider Directory
Tax ID family
Kidzcare Pediatrics PC28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1436313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760400000000",
    "number": "1760865760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9219",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283119082",
            "telephone_number": "910-483-7337",
            "fax_number": "910-483-0648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1606 WELLINGTON AVE STE F",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017704",
            "telephone_number": "910-392-5634",
            "fax_number": "910-392-5654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDZCARE PEDIATRICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-08",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A",
        "authorized_official_last_name": "LOCKHART",
        "authorized_official_first_name": "SHANTAE",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "910-483-7337"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "118386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2025; 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.