PEDIATRIA HEALTHCARE, LLC (NPI# 1518132406) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518132406 |
| Entity Type | Organization |
| Organization Name | PEDIATRIA HEALTHCARE, LLC |
| Other Organization Name | AVEANNA HEALTHCARE |
| Practice Address |
3492 Martin Hurst Rd Tallahassee FL 32312-1702 |
| Mailing Address |
400 Interstate North Pkwy Se Ste 1600 Atlanta GA 30339-5047 |
| Practice Telephone | 8507013920 |
| Practice Fax Number | 8507013924 |
| Mailing Telephone | 7702488740 |
| Mailing Fax Number | 7708401901 |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2019-07-11 |
| Authorized Official Name | VICKI WHITESIDE (DIRECTOR 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 |
60080986 | FL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 240024300 | 05 |
| Other Name | Type Code |
|---|---|
| Aveanna Healthcare | 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 |
| 1568633071 | Pediatria Healthcare, LLC | Nursing Care | 2420 Double Churches Rd Ste B, Columbus, GA 31909-2984 | 2008-03-13 |
| 1124296389 | Pediatria Healthcare, LLC | Clinic/Center | 25 Chatham Ctr S, Savannah, GA 31405-1302 | 2008-02-11 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Massachusetts Corporations | PEDIATRIA HEALTHCARE, LLC | 5185 Peachtree Parkway, Suite 350, Norcross, GA 30092-6545 |
| Street Address |
3492 MARTIN HURST RD |
| City | TALLAHASSEE |
| State | FL |
| Zip Code | 32312-1702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730793100 | Annie Catherine Willis | Occupational Therapy Assistant | 3492 Martin Hurst Rd, Tallahassee, FL 32312-1702 | 2020-09-03 |
| 1841824935 | Victoria Kistler | Occupational Therapy Assistant | 3492 Martin Hurst Rd, Tallahassee, FL 32312-1702 | 2020-02-27 |
| 1205476678 | Jessica Kingry | Occupational Therapist | 3492 Martin Hurst Rd, Tallahassee, FL 32312-1702 | 2020-01-13 |
| 1144868555 | Kellie Love Willis | Occupational Therapy Assistant | 3492 Martin Hurst Rd, Tallahassee, FL 32312-1702 | 2019-12-16 |
| 1851896518 | Cydney Close | Occupational Therapy Assistant | 3492 Martin Hurst Rd, Tallahassee, FL 32312-1702 | 2018-03-26 |
| 1306196126 | Jimmie Rhea Crain | Respiratory Therapist, Registered | 3492 Martin Hurst Rd, Tallahassee, FL 32312-1702 | 2012-09-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184274235 | Jennifer Stinson | Technician | 10014 Journeys En, Tallahassee, FL 32312 | 2019-09-19 |
| 1528581766 | Amanda Michele Chandler | Counselor | 2634 Capital Circle N.e., Tallahassee, FL 32312 | 2017-07-19 |
| 1902330871 | Therese Melendez | Recreation Therapist | 9346 Buck Haven Trl, Tallahassee, FL 32312 | 2017-04-17 |
| 1104373240 | Comfortable Care Dental Health Professionals, Pa | Dentist | 5442 Thomasville Rd, Suite 1, Tallahassee, FL 32312 | 2016-09-07 |
| 1568819753 | Kaydi Blackstock | Specialist/Technologist | 7200 Lawton Chiles Ln, Tallahassee, FL 32312 | 2016-05-18 |
| 1275994212 | Tiffany Coleman | Pharmacist | 6680 Thomasville Road, Tallahassee, FL 32312 | 2016-03-18 |
| 1659743235 | Psychological Center | Community/Behavioral Health | 8819 Minnow Creek Dr, Tallahassee, FL 32312 | 2015-10-22 |
| 1780098723 | Andrew Bellebaum | Dentist | 554 Keily Street Bureau of Med and Sur, Centralized Credentials and Privilegeing, Jacksonville, FL 32312 | 2014-06-18 |
| 1851714299 | Hf Acupuncture and Chinese Medicine Center LLC | Acupuncturist | 1282 Timberlane Rd, Tallahassee, FL 32312 | 2014-01-21 |
| 1629326061 | Ana E Raynolds | Speech-Language Pathologist | 3457 Cedarwood Trail, Tallahassee, FL 32312 | 2012-08-15 |
| Find all providers in zip 32312 | ||||
| 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 |
|---|---|---|---|---|
| 1326647363 | Shining Stars Pediatric Extended Care, LLC | Clinic/Center | 5201 Ravenswood Rd Ste 110, Ft Lauderdale, FL 33312-6004 | 2020-10-21 |
| 1275131575 | Angels On Earth Ppec, Inc. | Clinic/Center | 335 Pineda Ct Ste 104, Melbourne, FL 32940-7504 | 2020-10-09 |
| 1609488840 | Gencare Kids, LLC | Clinic/Center | 2557 E Irlo Bronson Memorial Hwy, Kissimmee, FL 34744-4993 | 2020-08-19 |
| 1659982742 | Banyan Pediatric Care Centers Pasco, LLC | Clinic/Center | 4008 Little Rd, New Port Richey, FL 34655-1719 | 2020-08-12 |
| 1205447398 | Banyan Pediatric Care Centers Sarasota, LLC | Clinic/Center | 3251 17th St Unit 200, Sarasota, FL 34235-8900 | 2020-08-12 |
| 1992330757 | Angels On Earth Ppec, Inc. | Clinic/Center | 110 Patterson Rd Ste 2, Haines City, FL 33844-7840 | 2020-03-11 |
| 1669004206 | Angels Special Care Inc | Clinic/Center | 17571 S Dixie Hwy, Palmetto Bay, FL 33157-5435 | 2020-02-11 |
| 1871132183 | Abc Pediatrics of Florida Inc | Clinic/Center | 14856 Nw 7th Ave, Miami, FL 33168-3106 | 2020-01-03 |
| 1548801848 | Caresquare of Florida LLC | Clinic/Center | 100 S Congress Ave Ste 2230e, Delray Beach, FL 33445-4642 | 2019-10-08 |
| 1326696758 | Pedikidz Ppec | Clinic/Center | 7800 Sw 87th Ave Ste A-100, Miami, FL 33173-3570 | 2019-08-28 |
| Find all providers with the same taxonomy | ||||
| City | TALLAHASSEE |
| Zip Code | 32312 |
Please comment or provide details below to improve the information on PEDIATRIA HEALTHCARE, LLC.
| 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.