PINEVILLE PEDIATRICSPLLC NPI 1679913651

NPI Information

NPI: 1679913651
Provider Name: PINEVILLE PEDIATRICS,PLLC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 34D2026814

Address:
10700 KETTERING DR
SUITE D
CHARLOTTE, NC
ZIP 28226
Phone: (704) 540-3036
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PINEVILLE PEDIATRICS,PLLC is a primary care clinic center in Charlotte, NC. PINEVILLE PEDIATRICS,PLLC NPI is 1679913651. The provider is registered as an organization entity type.

The provider's business location address is:

10700 KETTERING DR
SUITE D
CHARLOTTE, NC
ZIP 28226-770
Phone: (704) 540-3036

The provider's authorized official is Satya Jammalamadaka .
The authorized official title is Md and has the following contact phone number (704) 540-3036.

The CLIA number assigned to this NPI record is 34D2026814 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/5/2013 and was last updated on 7/5/2013.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	201001747	NORTH CAROLINA	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	5916594	MEDICAID	NORTH 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: 11/14/2023

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