Organization Active NPI

Just 4 Kids Pediatrics LLP

  • Pediatric Nurse Practitioner
  • Stafford, TX
National Provider Identifier
1962840074
Registry record updated Dec 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
603668 Issued in TX
Legal business name
JUST 4 KIDS PEDIATRICS LLP
Practice address
2503 S Main St
Suite C
Stafford, TX 77477-5544
Phone
(281) 261-5800
Fax
(281) 261-5885
NPI assigned
Jun 11, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2022

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

Authorized official

Name
Dr. Shainy Benny Varghese, PHD,RN,CPNP
Title
Director/Provider
Phone
(281) 261-5800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0200X 603668 TX Primary

Addresses

Primary practice location

2503 S Main St
Suite C
Stafford, TX 77477-5544

Mailing address

2503 S Main St
Suite C
Stafford, TX 77477-5544
Phone (281) 261-5800

Other identifiers 3

IdentifierTypeStateIssuer
537132OtherTXSTATE LICENCE
210617101MedicaidTX
603668OtherTXSTATE LICENSE

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
45D2014424Just 4 Kids Pediatrics LLP2503 S Main Street Suite C, Stafford, TX 77477Certificate of waiverOct 7, 2026

National Provider Directory

National Provider Directory

Locations

2503 S Main St
Ste C
Stafford, TX 77477
Phone (281) 261-5800

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1370908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671148800000",
    "number": "1962840074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2503 S MAIN ST",
            "address_2": "SUITE C",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774775544",
            "telephone_number": "281-261-5800",
            "fax_number": "281-261-5885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2503 S MAIN ST",
            "address_2": "SUITE C",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774775544",
            "telephone_number": "281-261-5800",
            "fax_number": "281-261-5885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUST 4 KIDS PEDIATRICS LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-11",
        "last_updated": "2022-12-16",
        "certification_date": "2022-12-16",
        "status": "A",
        "authorized_official_last_name": "VARGHESE",
        "authorized_official_first_name": "SHAINY",
        "authorized_official_middle_name": "BENNY",
        "authorized_official_title_or_position": "DIRECTOR/PROVIDER",
        "authorized_official_telephone_number": "281-261-5800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD,RN,CPNP"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "603668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENCE",
            "identifier": "537132",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "210617101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "603668",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stafford, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2022; 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.