Provider Type Icon

PEDIATRIC SERVICES OF AMERICA LLC NPI 1538191820


NPI Information

NPI: 1538191820
Provider Name: PEDIATRIC SERVICES OF AMERICA, LLC

Doing Business As: AVEANNA HEALTHCARE

Classification: Nursing Care - 251J00000X
Entity Type: Organization

CLIA Number: 11D0977713

Address:
4408 COLUMBIA RD
UNITS 100 & 102
MARTINEZ, GA
ZIP 30907
Phone: (706) 868-6543
Get Directions

PEDIATRIC SERVICES OF AMERICA, LLC is a nursing care in Martinez, GA. The provider is a Nursing Care Agency is an entity that provides skilled nursing care through the services of a Registered Nurse (RN) or a Licensed Practical Nurse (LPN), by employees, contracted individuals, or via a registry, in a variety of settings. The agency may engage in providing private duty nursing and/or staffing services. PEDIATRIC SERVICES OF AMERICA, LLC NPI is 1538191820. The provider is registered as an organization entity type.
The provider Is Doing Business As Aveanna Healthcare.

The provider's business location address is:

4408 COLUMBIA RD
UNITS 100 & 102
MARTINEZ, GA
ZIP 30907-554
Phone: (706) 868-6543
Fax: (706) 868-9754

The provider's authorized official is Shannon Drake .
The authorized official title is Chief Legal Officer and has the following contact phone number (470) 464-8000.

The CLIA number assigned to this NPI record is 11D0977713 - home health agency with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/7/2006 and was last updated on 2/26/2024.


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
1251E00000XHome Health121-R-0003GEORGIANo
2251J00000XNursing Care121-265HGEORGIAYes

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
100974278AMEDICAIDGEORGIA
2538807248BMEDICAIDGEORGIA
3EXG033MEDICAIDSOUTH CAROLINA
4538807248DMEDICAIDGEORGIA
5538807248EMEDICAIDGEORGIA
6EX0445MEDICAIDSOUTH 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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.