NPIMap

Organization Active NPI

Pediatria Healthcare, LLC

  • Medically Fragile Infants and Children Day Care
  • North Versailles, PA
National Provider Identifier
1770927345
Registry record updated Nov 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medically Fragile Infants and Children Day CareTaxonomy code 261QM3000X
Legal business name
PEDIATRIA HEALTHCARE, LLC
Practice address
1183 Jacks Run Rd
North Versailles, PA 15137-0000
Phone
(412) 349-6708
Fax
(412) 349-6716
NPI assigned
Apr 25, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2018

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

Authorized official

Name
Vicki Whiteside
Title
Director, Regulatory Licensing
Phone
(770) 248-8740

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medically Fragile Infants and Children Day Care 261QM3000X Primary

Addresses

Primary practice location

1183 Jacks Run Rd
North Versailles, PA 15137-0000

Mailing address

400 Interstate North Pkwy SE Ste 1600
Atlanta, GA 30339-5047
Phone (770) 248-8740

Other identifiers 1

IdentifierTypeStateIssuer
1021992800016MedicaidPA

Other names 1

  • Aveanna Healthcare Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pediatria Healthcare LLC26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

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

View all 25

Locations

1183 Jacks Run Rd
North Versailles, PA 15137
Phone (412) 349-6708

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1366848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543536000000",
    "number": "1770927345",
    "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": "770-248-8740",
            "fax_number": "770-248-8192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1183 JACKS RUN RD",
            "city": "NORTH VERSAILLES",
            "state": "PA",
            "postal_code": "151370000",
            "telephone_number": "412-349-6708",
            "fax_number": "412-349-6716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIA HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-25",
        "last_updated": "2018-11-30",
        "status": "A",
        "authorized_official_last_name": "WHITESIDE",
        "authorized_official_first_name": "VICKI",
        "authorized_official_title_or_position": "DIRECTOR, REGULATORY LICENSING",
        "authorized_official_telephone_number": "770-248-8740"
    },
    "taxonomies": [
        {
            "code": "261QM3000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medically Fragile Infants and Children Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1021992800016",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aveanna Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Versailles, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2018; 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.