PEDIATRIA HEALTHCARE, LLC (NPI# 1447492269) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447492269 |
| Entity Type | Organization |
| Organization Name | PEDIATRIA HEALTHCARE, LLC |
| Other Organization Name | PEDIATRIA HEALTHCARE FOR KIDS |
| Practice Address |
53 Gravel St Suite C Wilkes Barre PA 18705-3738 |
| Mailing Address |
400 Interstate North Pkwy Se Ste 1600 Atlanta GA 30339-5047 |
| Practice Telephone | 7708401966 |
| Practice Fax Number | 7708401901 |
| Mailing Telephone | 7702488740 |
| Mailing Fax Number | 7702488192 |
| Enumeration Date | 2009-03-25 |
| Last Update Date | 2018-11-30 |
| Authorized Official Name | VICKI WHITESIDE (DIRECTORY, REGULATORY LICENSING) |
| Authorized Official Telephone | 7702488740 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM3000X |
Clinic/Center Specialization: Medically Fragile Intants and Children Day Care |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 1021992800013 | 05 |
| Other Name | Type Code |
|---|---|
| Aveanna Healthcare | Doing Business As Name - Organization |
| Pediatria HealthCare for Kids | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194120063 | Pediatria Healthcare, LLC | Clinic/Center | 6459 Riverside Dr, Metairie, LA 70003-3206 | 2014-11-04 |
| 1770927345 | Pediatria Healthcare, LLC | Clinic/Center | 1183 Jacks Run Rd, North Versailles, PA 15137-0000 | 2013-04-25 |
| 1134563711 | Pediatria Healthcare, LLC | Home Health | 1185 Jacks Run Rd, S.r. 48, North Versailles, PA 15137-2725 | 2013-04-25 |
| 1508168170 | Pediatria Healthcare, LLC | Home Health | 1167 N Washington St Ste E, Wilkes Barre, PA 18705-1856 | 2010-12-02 |
| 1366684185 | Pediatria Healthcare, LLC | Nursing Care | 2935 N Ashley St Ste 103, Valdosta, GA 31602-1786 | 2009-03-25 |
| 1528210267 | Pediatria Healthcare, LLC | Physical Therapist | 1236 Blountstown Hwy, Building 5, Tallahassee, FL 32304-2715 | 2008-10-14 |
| 1427225523 | Pediatria Healthcare, LLC | Home Health | 7 Harvard St Ste 220, Brookline, MA 02445 | 2008-05-08 |
| 1811162639 | Pediatria Healthcare, LLC | Clinic/Center | 353 Markle Dr, Harrisburg, PA 17111-2762 | 2008-04-23 |
| 1518132406 | Pediatria Healthcare, LLC | Clinic/Center | 3492 Martin Hurst Rd, Tallahassee, FL 32312-1702 | 2008-04-23 |
| 1568633071 | Pediatria Healthcare, LLC | Nursing Care | 2420 Double Churches Rd Ste B, Columbus, GA 31909-2984 | 2008-03-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Massachusetts Corporations | PEDIATRIA HEALTHCARE, LLC | 5185 Peachtree Parkway, Suite 350, Norcross, GA 30092-6545 |
| Street Address |
53 GRAVEL ST SUITE C |
| City | WILKES BARRE |
| State | PA |
| Zip Code | 18705-3738 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528266020 | Teressa Ann Polinsky | Pharmacist | 53 Gravel St, Wilkes Barre, PA 18705-3738 | 2007-07-05 |
| 1184014342 | Lisa Midwinter | Speech-Language Pathologist | 53 Gravel St, Wilkes Barre, PA 18705-3738 | 2015-01-27 |
| 1275923435 | Susan Balint | Speech-Language Pathologist | 53 Gravel St, Wilkes Barre, PA 18705-3738 | 2015-01-27 |
| 1194072819 | Leesa Jane Masteller | Physical Therapist | 53 Gravel St, Wilkes Barre, PA 18705-3738 | 2012-08-13 |
| 1013273341 | Amy Anne Hummel | Occupational Therapist | 53 Gravel St, Wilkes Barre, PA 18705-3738 | 2012-04-11 |
| 1144531286 | Noelle Marie Benderavich | Occupational Therapist | 53 Gravel St, Wilkes Barre, PA 18705-3738 | 2010-06-23 |
| 1336474808 | Erin Poperowitz | Speech-Language Pathologist | 53 Gravel St, Wilkes Barre, PA 18705-3738 | 2009-10-16 |
| 1275868853 | Margaret T Fritz | Speech-Language Pathologist | 53 Gravel St, Wilkes Barre, PA 18705-3738 | 2009-10-15 |
| 1992938732 | Julie Miller | Speech-Language Pathologist | 53 Gravel St, Wilkes Barre, PA 18705-3738 | 2009-08-27 |
| 1831321736 | Jean L Fredmund | Physical Therapist | 53 Gravel St, Wilkes Barre, PA 18705-3738 | 2009-08-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316446206 | Mark L Rowan | Physical Therapist | 667 North River Street, Plains, PA 18705 | 2018-02-06 |
| 1588105589 | Maxim Healthcare Services Inc | Home Health | 672 North River St., Suite 102, Plains, PA 18705 | 2017-03-10 |
| 1538572383 | Kevin Loftus | Pharmacist | 20 South River St, Plains, PA 18705 | 2014-06-10 |
| 1831345487 | Terry Lynn Elias | Speech-Language Pathologist | 1014 Morgan Drive, Wilkes-barre, PA 18705 | 2008-08-14 |
| 1578699963 | Renee Elizabeth Edwards | Dentist | 163 S River Street, Plains, PA 18705 | 2007-02-27 |
| 1669568770 | Wyoming Valley Alcohol and Drug Services Inc | Counselor | 437 North Main St., Wilkes Barre, PA 18705 | 2006-10-05 |
| 1912090689 | Emmanuel Egipto Jacob | Acupuncturist | 39 South River Street, Plains, PA 18705 | 2006-10-02 |
| 1336159508 | Albert David Janerich | Physical Medicine & Rehabilitation | 667 S River St, Plains, PA 18705 | 2006-08-09 |
| 1174543094 | Northeast Pedorthic Services Inc | Durable Medical Equipment & Medical Supplies | 234 S River Rd, Plains, PA 18705 | 2006-07-21 |
| 1235118225 | Riverview Orthotics Prosthetics Inc | Prosthetic/Orthotic Supplier | 220 South River St, Suite 204, Plains, PA 18705 | 2006-01-10 |
| Find all providers in zip 18705 | ||||
| Taxonomy Code | 261QM3000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medically Fragile Intants and Children Day Care |
| An entity, facility, or distinct part of a facility specially equipped and staffed to provide care for medically fragile children with varied and complex care needs (e.g., enteral or parental feeding, ostomy care, respiratory/ventilator care, medications and therapies, etc.). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639305048 | Pediatriahealthcarellc | Clinic/Center | 53 Gravel St, Wilkes Barre, PA 18705-3738 | 2009-06-01 |
| 1720214133 | Pediatria Healthcare,llc | Clinic/Center | 53 Gravel St, Wilkes Barre, PA 18705-3738 | 2009-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225656739 | 15 Wesner Lane Pecc Operating Company, Lp | Clinic/Center | 15 Wesner Ln Ste 101, Danville, PA 17821-8023 | 2020-07-10 |
| 1770927345 | Pediatria Healthcare, LLC | Clinic/Center | 1183 Jacks Run Rd, North Versailles, PA 15137-0000 | 2013-04-25 |
| 1154639847 | Frankies World Foundation | Clinic/Center | 1011 Poplar St, Philadelphia, PA 19123-1962 | 2010-09-16 |
| 1811162639 | Pediatria Healthcare, LLC | Clinic/Center | 353 Markle Dr, Harrisburg, PA 17111-2762 | 2008-04-23 |
| 1235277690 | Lauren's House, LLC | Clinic/Center | 17 Creek Pkwy, Suite 200, Boothwyn, PA 19061-3148 | 2007-02-01 |
| 1699813063 | Lauren's House North Philadelphia, LLC | Clinic/Center | 1318 W Clearfield St, Suite 300, Philadelphia, PA 19132-2423 | 2007-02-01 |
| 1285770917 | Children's Cognitive and Behavioral Health Inc. | Clinic/Center | 211 South St Ste 637, Philadelphia, PA 19147-2305 | 2007-01-29 |
| 1467506626 | Helping Hand Childre's Center | Clinic/Center | 2159 Oregon Pike, Lancaster, PA 17601-4604 | 2007-01-23 |
| 1992041495 | Wonder Kids Medical Daycare | Clinic/Center | 647 E Roseville Rd, Lancaster, PA 17601-4235 | 2013-01-02 |
| 1548557879 | Pediatria Healthcare, LLC | Clinic/Center | 8101 Washington Ln, Suite 102, Wyncote, PA 19095-1625 | 2011-07-07 |
| Find all providers with the same taxonomy | ||||
| City | WILKES BARRE |
| Zip Code | 18705 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.