NPIMap

Organization Active NPI

Pediatria Healthcare, LLC

Doing business as Aveanna Healthcare

  • Medically Fragile Infants and Children Day Care
  • Shreveport, LA
National Provider Identifier
1922409069
Registry record updated Jan 27, 2025
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
Doing business as
Aveanna Healthcare
Practice address
385 Bert Kouns Industrial Loop
Suite 600
Shreveport, LA 71106-8158
Phone
(318) 415-7625
Fax
(318) 415-7630
NPI assigned
Sep 9, 2014
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 1

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

Addresses

Primary practice location

385 Bert Kouns Industrial Loop
Suite 600
Shreveport, LA 71106-8158

Mailing address

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

Other names 1

  • Aveanna Healthcare Doing business as

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
19D2083631Aveanna Healthcare385 Bert Kouns Industrial Loop, Suite 600, Shreveport, LA 71106Certificate of waiverSep 8, 2026

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

385 Bert Kouns Industrial Loop
Ste 600
Shreveport, LA 71106
Phone (318) 415-7625

NPI Registry JSON

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

{
    "created_epoch": "1410220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737936000000",
    "number": "1922409069",
    "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": "385 BERT KOUNS INDUSTRIAL LOOP",
            "address_2": "SUITE 600",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711068158",
            "telephone_number": "318-415-7625",
            "fax_number": "318-415-7630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIA HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-09",
        "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": "261QM3000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medically Fragile Infants and Children Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aveanna Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shreveport, LA

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.
  • 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.