PEDIATRIC ASSOCIATES NPI 1013954510

NPI Information

  • NPI: 1013954510
  • Provider Name: PEDIATRIC ASSOCIATES
  • Classification: Clinic/Center - 261QR1300X
  • Specialization: Rural Health
  • Entity Type: Organization
  • Doing Business As: RED RIVER HEALTH CARE
  • CLIA Number: 18D0982356
  • Address: 321C E COLLEGE AVE
    STANTON, KY
    ZIP 40380
  • Phone: (606) 663-9797

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NPI Details

PEDIATRIC ASSOCIATES is a rural health clinic center in Stanton, KY. PEDIATRIC ASSOCIATES NPI is 1013954510. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Red River Health Care.

The provider's business location address is:

321C E COLLEGE AVE
STANTON, KY
ZIP 40380-325
Phone: (606) 663-9797
Fax: (606) 663-9470

The provider's authorized official is Djien Hwat So .
The authorized official title is Operating Manager and has the following contact phone number (606) 432-0174.

The CLIA number assigned to this NPI record is 18D0982356 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/1/2006 and was last updated on 3/21/2017.

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
1208000000XPediatrics900183KENTUCKYNo
2363LF0000XNurse PractitionerFamily3006123KENTUCKYNo
3363A00000XPhysician AssistantPA1161KENTUCKYNo
4261QR1300XClinic/CenterRural Health900183KENTUCKYYes

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
1183934MEDICARE OSCAR/CERTIFICATION
29525MEDICARE PINKENTUCKY
335001783MEDICAIDKENTUCKY

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: 11/21/2025

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