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KIDZCARE PEDIATRICS PC NPI 1548495914


NPI Information

NPI: 1548495914
Provider Name: KIDZCARE PEDIATRICS, PC

Former Legal Business Name: PEDIATRIC ASSOCIATES, PC

Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 34D0244865

Address:
3115 BORDEAUX PARK DR
FAYETTEVILLE, NC
ZIP 28306
Phone: (910) 307-7337
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KIDZCARE PEDIATRICS, PC is a pediatrics in Fayetteville, NC. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. KIDZCARE PEDIATRICS, PC NPI is 1548495914. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Pediatric Associates, Pc.

The provider's business location address is:

3115 BORDEAUX PARK DR
FAYETTEVILLE, NC
ZIP 28306
Phone: (910) 307-7337
Fax: (910) 323-4620

The provider's authorized official is Shantae Renee Lockhart .
The authorized official title is Credentials Specialist and has the following contact phone number (910) 483-7337.

The CLIA number assigned to this NPI record is 34D0244865 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/28/2009 and was last updated on 8/27/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1016VROTHERNORTH CAROLINABCBS
25908525MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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