KID CARE PEDIATRIC URGENT CARE LLC NPI 1255039707

NPI Information

NPI: 1255039707
Provider Name: KID CARE PEDIATRIC URGENT CARE, LLC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

CLIA Number: 42D2277320

Address:
212 MAIN ST STE A
CONWAY, SC
ZIP 29526
Phone: (843) 340-2672
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KID CARE PEDIATRIC URGENT CARE, LLC is a family nurse practitioner in Conway, SC. KID CARE PEDIATRIC URGENT CARE, LLC NPI is 1255039707. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

212 MAIN ST STE A
CONWAY, SC
ZIP 29526-129
Phone: (843) 340-2672

The provider's authorized official is Summer Watts .
The authorized official title is Fnp and has the following contact phone number (843) 340-2672.

The CLIA number assigned to this NPI record is 42D2277320 - other - location pediatric urgent with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/22/2023 and was last updated on 2/22/2023.

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	363LF0000X	Nurse Practitioner	Family			Yes

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: 5/5/2024

NPI Synchronization or Removal

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