Active NPI
Pediatric Services of America, LLC
- Nursing Care Agency
- Raleigh, NC
National Provider Identifier
1962431577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Care Agency
- License
- HC0446
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3408666 | Medicaid | NC | |
| 7100324 | Medicaid | NC |
Other names 1
- Aveanna Healthcare
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 34D0933804 | Pediatric Services of America, LLC | Certificate of waiver | Sep 22, 2027 |
National Provider Directory
National Provider Directory- Tax ID family
- Sleep Disorder Serv of
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.
-
- Nursing Care Agency
- Raleigh, NC
- NPI 1114955309
-
- Nursing Care Agency
- Fayetteville, NC
- NPI 1174552665
-
- Nursing Care Agency
- Charlotte, NC
- NPI 1346278157
-
- Nursing Care Agency
- Greenville, NC
- NPI 1992729362
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.