Starkville Pediatric Extended Care LLC

Primary specialty

Medically Fragile Infants and Children Day CareTaxonomy code 261QM3000X

Legal business name

STARKVILLE PEDIATRIC EXTENDED CARE LLC

Practice address

9771 Ms Highway 25
Starkville, MS 39759-4944

Phone

(251) 232-1518

NPI assigned

Jul 26, 2020

Last updated

Jul 26, 2020By 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

Mark Hammond

Title

Owner

Phone

(251) 232-1518

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": "1595721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595721600000",
    "number": "1780293787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8178 SOLDIER CT",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "365266135",
            "telephone_number": "251-232-1518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9771 MS HIGHWAY 25",
            "city": "STARKVILLE",
            "state": "MS",
            "postal_code": "397594944",
            "telephone_number": "251-232-1518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STARKVILLE PEDIATRIC EXTENDED CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-26",
        "last_updated": "2020-07-26",
        "certification_date": "2020-07-26",
        "status": "A",
        "authorized_official_last_name": "HAMMOND",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "251-232-1518"
    },
    "taxonomies": [
        {
            "code": "261QM3000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medically Fragile Infants and Children Day Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Starkville Oktibbeha Consolidated School District (Starkville High School)
• Starkville Orthopedic Clinic, LLC
• Starkville Peak Performance LLC
• Starkville Pediatric Clinic
• Starkville Pediatric Dentistry
• Starkville Physical Therapy, Inc. (Starkville Physical Therapy)
• Starkville Public Schools
• Starkville Radiology PLLC
• Starkville School District
• Starkville School District

• Medically Fragile Infants and Children Day Care in Starkville, MS
• Providers in Starkville, 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 Jul 26, 2020; 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.