KIDS CARE PEDIATRICS PA (NPI# 1487612628) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487612628 |
| Entity Type | Organization |
| Organization Name | KIDS CARE PEDIATRICS PA |
| Practice Address |
101 Kellie Dr Smithfield NC 27577-9443 |
| Practice Telephone | 9199383749 |
| Practice Fax Number | 9199383795 |
| Mailing Telephone | 9199383749 |
| Mailing Fax Number | 9199383795 |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2013-07-09 |
| Authorized Official Name | DR. PENNIE S BLISS (PRESIDENT) |
| Authorized Official Telephone | 9199383749 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
147337 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 8902042 | 05 |
| Street Address |
101 KELLIE DR |
| City | SMITHFIELD |
| State | NC |
| Zip Code | 27577-9443 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720640568 | Shelli Hoyes | Registered Nurse | 101 Kellie Dr, Smithfield, NC 27577-9443 | 2019-07-02 |
| 1467954396 | Caroline Bernthal | Nurse Practitioner | 101 Kellie Dr, Smithfield, NC 27577-9443 | 2018-03-07 |
| 1427500982 | Kate Elizabeth Houghtalen | Registered Nurse | 101 Kellie Dr, Smithfield, NC 27577-9443 | 2016-11-01 |
| 1467817353 | Jacqueline Grooms Oliver | Nurse Practitioner | 101 Kellie Dr, Smithfield, NC 27577-9443 | 2015-12-21 |
| 1174826952 | Lori Beth Bailey | Registered Nurse | 101 Kellie Dr, Smithfield, NC 27577-9443 | 2010-12-16 |
| 1013065390 | Karen H Merritt | Nurse Practitioner | 101 Kellie Dr, Smithfield, NC 27577-9443 | 2007-01-05 |
| 1346298973 | Lisa M.l. Parker | Pediatrics | 101 Kellie Dr, Smithfield, NC 27577-9443 | 2006-05-05 |
| 1629036256 | Debra J Tetreault | Pediatrics | 101 Kellie Dr, Smithfield, NC 27577-9443 | 2006-05-03 |
| 1558329110 | Penelope S Bliss | Pediatrics | 101 Kellie Dr, Smithfield, NC 27577-9443 | 2006-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851919047 | Sherwin Cuaresma Bernardino | Physical Therapist | Meadowview Assisted Living Center, 250 Nc-210, Smithfield, NC 27577 | 2020-07-14 |
| 1386297299 | Johnston Opco, LLC | Non-emergency Medical Transport (VAN) | 200 Kellie Dr, Smithfield, NC 27577 | 2019-07-19 |
| 1790255362 | Adrian Brook Taylor | Physical Therapist | 540 North Street, Smithfield, NC 27577 | 2018-11-27 |
| 1497260608 | Providence Healthcare of The Carolinas | Assisted Living Facility | 4302 Hwy Nc 210, Smithfield, NC 27577 | 2017-12-11 |
| 1720593908 | Latorya Delois Moore | Nurse Practitioner | 514 N Brightleaf Blvd Ste 1100, Smithfield, NC 27577 | 2017-12-09 |
| 1124546171 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 104 N Brightleaf Blvd, Smithfield, NC 27577 | 2017-08-30 |
| 1316482201 | Providence Pain, Spine & Recovery, Pllc | Anesthesiology | 7 Berkshire Rd, Smithfield, NC 27577 | 2016-12-30 |
| 1407203318 | Linda Pearl Trujillo | Early Intervention Provider Agency | 623 Tralee Dr, Smithfield, NC 27577 | 2016-05-20 |
| 1336500206 | Saundra Casey | Counselor | 15 Noble Street, Smithfield, NC 27577 | 2016-03-18 |
| 1639537707 | Ralph Edwin Wilson Jr. | Physician Assistant | 100 Kellie Drive, Smithfield, NC 27577 | 2016-02-04 |
| Find all providers in zip 27577 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699162438 | William Lowell | Pediatrics | 18055 Morgarts Beach Rd, Smithfield, VA 23430-2621 | 2015-04-20 |
| 1093096141 | Sunshine Pediatrics, Pa | Pediatrics | 1519 Booker Dairy Rd, Smithfield, NC 27577-9472 | 2011-09-02 |
| 1063570224 | Stephanie Jo Penchuk | Pediatrics | 41 Sanderson Rd Ste 202, Smithfield, RI 02917-2603 | 2006-12-04 |
| 1093809782 | Kimberly D Fox | Pediatrics | 1519 E Booker Dairy Rd, Smithfield, NC 27577-9472 | 2006-10-03 |
| 1831159391 | Sally Lawson Carpenter | Pediatrics | 11 Berkshire Rd, Smithfield, NC 27577-4748 | 2006-03-27 |
| 1609066273 | Johnston County Pediatrics | Pediatrics | 11 Berkshire Rd, Smithfield, NC 27577 | 2007-07-30 |
| 1528121191 | Trella Cooper | Pediatrics | 517 N Brightleaf Blvd, Smithfield, NC 27577-4407 | 2006-12-18 |
| 1255499752 | Johnston County Pediatrics | Pediatrics | 11 Berkshire Rd, Smithfield, NC 27577-4748 | 2006-12-05 |
| 1073547030 | Dinusha W Dietrich | Pediatrics | 41 Sanderson Rd, Ste 202, Smithfield, RI 02917-2603 | 2006-07-10 |
| 1346298973 | Lisa M.l. Parker | Pediatrics | 101 Kellie Dr, Smithfield, NC 27577-9443 | 2006-05-05 |
| Find all providers in SMITHFIELD | ||||
| City | SMITHFIELD |
| Zip Code | 27577 |
Please comment or provide details below to improve the information on KIDS CARE PEDIATRICS PA.
| 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.