Active NPI
Just 4 Kids Pediatrics LLP
- Pediatric Nurse Practitioner
- Stafford, TX
National Provider Identifier
1962840074
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 603668
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 537132 | Other | TX | STATE LICENCE |
| 210617101 | Medicaid | TX | |
| 603668 | Other | TX | STATE LICENSE |
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 |
|---|---|---|---|
| 45D2014424 | Just 4 Kids Pediatrics LLP | Certificate of waiver | Oct 7, 2026 |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Primary Care Nurse Practitioner
- Stafford, TX
- NPI 1568785178
Pediatrics
-
- Family Nurse Practitioner
- Stafford, TX
- NPI 1255029161
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.