The Kidz Club- St Pete, LLC

Primary specialty

Pediatric Skilled Nursing FacilityTaxonomy code 3140N1450X

Legal business name

THE KIDZ CLUB- ST PETE, LLC

Doing business as

The Kidz Club- St. Pete

Practice address

850 3Rd Ave S
St Petersburg, FL 33701-4010

Phone

(727) 821-5439

Fax

(727) 821-9459

NPI assigned

Jun 21, 2011

Organization subpart

Yes

Parent organization

KY PPEC, INCAs reported in NPPES

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

Authorized official

Name

Richard C White

Title

Coo

Phone

(502) 210-5538

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• The Kidz Club- St. Pete Doing business as

Tax ID family

The Kidz Club2 organizations share this tax ID, including this one

Part of

Kyppecinc

Other organizations with this tax ID 1

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

• The Kidz Club- St Pete,LLC

  dba The Kidz Club

  • Pediatric Skilled Nursing Facility
  • Louisville, KY
  • NPI 1356687222
  NPD tax ID

Locations

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

{
    "created_epoch": "1308614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431993600000",
    "number": "1932495702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 HERR LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402224301",
            "telephone_number": "502-210-5538",
            "fax_number": "502-327-5098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 3RD AVE S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014010",
            "telephone_number": "727-821-5439",
            "fax_number": "727-821-9459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE KIDZ CLUB- ST PETE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KY PPEC, INC",
        "enumeration_date": "2011-06-21",
        "last_updated": "2015-05-19",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "502-210-5538"
    },
    "taxonomies": [
        {
            "code": "227800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Respiratory Therapist, Certified",
            "state": "FL",
            "license": "002082100",
            "primary": false
        },
        {
            "code": "3140N1450X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003967600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Kidz Club- St. Pete",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pediatric Skilled Nursing Facility in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Pediatric Skilled Nursing Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2015; 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.