Organization Active NPI

Pediatric Services of America, LLC

  • Nursing Care Agency
  • Raleigh, NC
National Provider Identifier
1962431577
Registry record updated Apr 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Care AgencyTaxonomy code 251J00000X
License
HC0446 Issued in NC
Legal business name
PEDIATRIC SERVICES OF AMERICA, LLC
Practice address
222 N Person St Ste 205
Raleigh, NC 27601-1067
Phone
(919) 481-6712
Fax
(919) 481-9883
NPI assigned
Jul 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2026

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
Nursing Care Agency 251J00000X HC0446 NC Primary

Addresses

Primary practice location

222 N Person St Ste 205
Raleigh, NC 27601-1067

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
3408666MedicaidNC
7100324MedicaidNC

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
34D0933804Pediatric Services of America, LLC222 N Person Street, Suite 205, Raleigh, NC 27601Certificate of waiverSep 22, 2027

National Provider Directory

National Provider Directory
Tax ID family
Sleep Disorder Serv of76 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 4

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

222 N Person St
Ste 205
Raleigh, NC 27601
Phone (919) 481-6712

1551 Westbrook Plaza Dr
Ste 110
Winston Salem, NC 27103

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775347200000",
    "number": "1962431577",
    "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": "222 N PERSON ST STE 205",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276011067",
            "telephone_number": "919-481-6712",
            "fax_number": "919-481-9883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC SERVICES OF AMERICA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-03",
        "last_updated": "2026-04-05",
        "certification_date": "2026-04-05",
        "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": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "NC",
            "license": "HC0446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3408666",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100324",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aveanna Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2026; 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.