PEDIATRIA HEALTHCARE, LLC (NPI# 1922409069) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922409069 |
| Entity Type | Organization |
| Organization Name | PEDIATRIA HEALTHCARE, LLC |
| Other Organization Name | AVEANNA HEALTHCARE |
| Practice Address |
385 Bert Kouns Industrial Loop Suite 600 Shreveport LA 71106-8158 |
| Mailing Address |
400 Interstate North Pkwy Se Ste 1600 Atlanta GA 30339-5047 |
| Practice Telephone | 3184157625 |
| Practice Fax Number | 3184157630 |
| Mailing Telephone | 7702488740 |
| Mailing Fax Number | 7702488192 |
| Enumeration Date | 2014-09-09 |
| 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 |
Ambulatory Health Care Facilities |
| 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 |
| Street Address |
385 BERT KOUNS INDUSTRIAL LOOP SUITE 600 |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71106-8158 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609837020 | Michelle R Ritter | Orthopaedic Surgery | 385 Bert Kouns Industrial Loop, Suite 500, Shreveport, LA 71106-8158 | 2006-03-28 |
| 1063862340 | Osc Anesthesia, LLC | Anesthesiology | 385 Bert Kouns Industrial Loop, Bldg 300, Shreveport, LA 71106-8158 | 2016-06-16 |
| 1922466788 | Julianna Claire Aaron | Nurse Practitioner | 385 Bert Kouns Industrial Loop, Suite 100, Shreveport, LA 71106-8158 | 2016-02-08 |
| 1285092056 | April Nicole Bedingfield | Nurse Practitioner | 385 Bert Kouns Industrial Loop, # 100, Shreveport, LA 71106-8158 | 2016-02-08 |
| 1376936542 | Shreveport Anesthesia Providers LLC | Anesthesiology | 385 Bert Kouns Industrial Loop, Bldg 300, Shreveport, LA 71106-8158 | 2015-03-12 |
| 1962840850 | Karen Leigh Haynie | Dentist | 385 Bert Kouns Industrial Loop, Suite 700, Shreveport, LA 71106-8158 | 2013-06-12 |
| 1316383524 | David S Drummond | Podiatrist | 385 Bert Kouns Industrial Loop, Suite 200, Shreveport, LA 71106-8158 | 2013-05-14 |
| 1376771154 | Ahp of Northwestern Louisiana LLC | Anesthesiology | 385 Bert Kouns Industrial Loop, Building 300, Shreveport, LA 71106-8158 | 2009-06-30 |
| 1144491614 | Ambulatory Surgery Center of Louisiana | Clinic/Center | 385 Bert Kouns Industrial Loop, Bldg 300, Shreveport, LA 71106-8124 | 2008-03-12 |
| 1700819752 | Center for Hand Surgery, Inc. | Orthopaedic Surgery | 385 Bert Kouns Industrial Loop, Suite 500, Shreveport, LA 71106-8158 | 2006-07-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972008332 | Andrew Joseph Brouillette | Dentist | 385 Bert Kouns Industrial Loop Ste 700, Shreveport, LA 71106 | 2018-03-28 |
| 1548775885 | David Wayne Spears | Pharmacist | 10460 Norris Ferry Road, Shreveport, LA 71106 | 2017-12-08 |
| 1225559263 | Susan Anderson Roblow | Physical Therapist | 921 Unadilla Street, Shreveport, LA 71106 | 2017-06-29 |
| 1134656382 | James Lowder | Dentist | 8691 Line Ave Ste 300, Shreveport, LA 71106 | 2017-05-18 |
| 1144753708 | Laverne Brantley | Counselor | 328 E 69th St, Shreveport, LA 71106 | 2017-04-10 |
| 1437690849 | Biostat Laboratories, LLC | Clinical Medical Laboratory | 9742 Saint Vincent Ave Ste 200, Shreveport, LA 71106 | 2017-03-17 |
| 1841730728 | Cedric Thomas | Case Manager/Care Coordinator | 6811 Fairfield Avenue, Shreveport, LA 71106 | 2017-02-27 |
| 1225576192 | Nick Vergis | Pharmacist | 5828 Line Avenue, Shreveport, LA 71106 | 2017-02-10 |
| 1184162554 | Marilyn Johnson | Case Manager/Care Coordinator | 9245 Wallace Lake Rd Ste A, Shreveport, LA 71106 | 2017-02-06 |
| 1417499740 | Pamela Lee | Counselor | 8802 Coyth Ln, Shreveport, LA 71106 | 2016-11-17 |
| Find all providers in zip 71106 | ||||
| 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 |
|---|---|---|---|---|
| 1467883181 | Caring Hands Pediatric Day Health Center, LLC | Clinic/Center | 1009 Professional Dr W, Shreveport, LA 71105-5624 | 2013-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174120612 | Pediatrust Acadiana, LLC | Clinic/Center | 331 Doucet Rd, Lafayette, LA 70503-3447 | 2020-10-07 |
| 1629474192 | Thibodaux Pdhc, LLC | Clinic/Center | 124 Sucre Ln, Thibodaux, LA 70301-4214 | 2014-11-11 |
| 1194120063 | Pediatria Healthcare, LLC | Clinic/Center | 6459 Riverside Dr, Metairie, LA 70003-3206 | 2014-11-04 |
| 1457753808 | Prescribed Pediatric Extended Center Inc | Clinic/Center | 2644 N Causeway Blvd, Suite 100, Metairie, LA 70002-6055 | 2014-09-17 |
| 1265844013 | Prescribed Pediatric Extended Care, Inc | Clinic/Center | 5505 Jackson St, Alexandria, LA 71303-2324 | 2014-05-28 |
| 1568896561 | Lauve's Pdhc, LLC | Clinic/Center | 2000 E Texas St, Bossier City, LA 71111-3830 | 2013-08-26 |
| 1619300506 | Prescribed Pediatric Extended Care, Inc | Clinic/Center | 2570 Sw Railroad Ave, Hammond, LA 70403-1514 | 2013-08-14 |
| 1598029092 | In Loving Arms, LLC | Clinic/Center | 6637 N Foster Dr, Baton Rouge, LA 70811-6164 | 2012-06-28 |
| 1093172058 | Pelican Pediatric Day Health Care Center, LLC | Clinic/Center | 400 Martin Luther King Jr Dr, Suite F, Natchitoches, LA 71457-4056 | 2016-01-21 |
| 1629493770 | Rapides Pediatric Day Health Care, LLC | Clinic/Center | 3212 Industrial St, Alexandria, LA 71301 | 2014-02-26 |
| Find all providers with the same taxonomy | ||||
| City | SHREVEPORT |
| Zip Code | 71106 |
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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.