NPIMap

Organization Active NPI

Smart Start Pediatrics LLC

  • Rural Health Clinic/Center
  • Albertville, AL
National Provider Identifier
1982020756
Registry record updated Jan 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
SMART START PEDIATRICS LLC
Practice address
460 Al Highway 75 N
Albertville, AL 35951-3838
Phone
(256) 891-0300
Fax
(256) 891-7461
NPI assigned
Mar 17, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2018

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

Authorized official

Name
Lashea Dalton
Title
Credentialing Contact/Office Manage
Phone
(256) 891-0300

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X
Rural Health Clinic/Center 261QR1300X AL Primary

Addresses

Primary practice location

460 Al Highway 75 N
Albertville, AL 35951-3838

Mailing address

460 Al Highway 75 N
Albertville, AL 35951-3838
Phone (256) 891-0300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160906000503 AL Part A Provider - Rural Health Clinic 7517253362 Practice locations: Albertville, AL

Rural health clinic certification: CCN 018925

Legal name
SMART START PEDIATRICS LLC
Doing business as
SMART START PEDIATRICS
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Nov 4, 2016
Last certification
Nov 4, 2016
Ownership / control type
1C
Organization structure
LLCProprietary
Incorporated
Feb 18, 2014 in AL
Enrollment address
460 Al Highway 75 N
Albertville, AL 35951-3838

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
01D0710895Smart Start Pediatrics LLC460 Al Hwy 75 N, Albertville, AL 35951Certificate of waiverOct 18, 2026

National Provider Directory

National Provider Directory

Locations

460 AL Highway 75 N
Albertville, AL 35951
Phone (256) 891-0300

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Peter Strogov Individual 5% Or Greater Direct Ownership Interest Jul 1, 2016 50%
Operational/Managerial ControlMedical Director Jul 1, 2016
Tracy Bell Individual 5% Or Greater Direct Ownership Interest Jul 1, 2016 50%
W-2 Managing EmployeePractice Manager Aug 1, 2019 100%

Practitioners & affiliated clinicians

Practitioners 8

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": "1395014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517184000000",
    "number": "1982020756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 AL HIGHWAY 75 N",
            "city": "ALBERTVILLE",
            "state": "AL",
            "postal_code": "359513838",
            "telephone_number": "256-891-0300",
            "fax_number": "256-891-7461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 AL HIGHWAY 75 N",
            "city": "ALBERTVILLE",
            "state": "AL",
            "postal_code": "359513838",
            "telephone_number": "256-891-0300",
            "fax_number": "256-891-7461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMART START PEDIATRICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-17",
        "last_updated": "2018-01-29",
        "status": "A",
        "authorized_official_last_name": "DALTON",
        "authorized_official_first_name": "LASHEA",
        "authorized_official_title_or_position": "CREDENTIALING CONTACT/OFFICE MANAGE",
        "authorized_official_telephone_number": "256-891-0300"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "AL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albertville, AL

Sources for this page

Verify at the official NPI Registry.