LITTLE PINE PEDIATRICS PLLC (NPI# 1497007553) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497007553 |
| Entity Type | Organization |
| Organization Name | LITTLE PINE PEDIATRICS PLLC |
| Other Organization Name | LITTLE PINE PEDIATRICS OF MADISON |
| Practice Address |
194 Ne Hancock Ave Madison FL 32340-2546 |
| Mailing Address |
1702 S Jefferson St Perry FL 32348-5611 |
| Practice Telephone | 8502532275 |
| Mailing Telephone | 8555775437 |
| Enumeration Date | 2012-10-12 |
| Last Update Date | 2016-02-08 |
| Authorized Official Name | DR. RONALD EMERICK JR. (OWNER) |
| Authorized Official Telephone | 8555775437 |
| Authorized Official Credential | DO |
| Is Organization Subpart | Y |
| Parent Organization Name | LITTLE PINE PEDIATRICS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QP2300X |
Clinic/Center Specialization: Primary Care |
HCC10208 | FL | Ambulatory Health Care Facilities |
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 001165802 | 05 |
| Other Name | Type Code |
|---|---|
| Little Pine Pediatrics of Madison | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528621331 | Little Pine Pediatrics Pllc | Pediatrics | 205 N Mulberry St, Monticello, FL 32344-1423 | 2019-04-17 |
| 1043661994 | Little Pine Pediatrics Pllc | Pediatrics | 15260 Nw 147th Dr, Suite 200, Alachua, FL 32615-5338 | 2016-06-22 |
| Street Address |
194 NE HANCOCK AVE |
| City | MADISON |
| State | FL |
| Zip Code | 32340-2546 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760428288 | William R. Primas | Family Medicine | 194 Ne Hancock Ave, Madison, FL 32340-2546 | 2006-06-22 |
| 1952804247 | Melissa Nash | Nurse Practitioner | 194 Ne Hancock Ave, Madison, FL 32340-2546 | 2018-03-13 |
| 1043761539 | Little Pine Pediatrics, Pllc | Clinic/Center | 194 Ne Hancock Ave, Madison, FL 32340-2546 | 2016-10-19 |
| 1851844112 | Sarah Garrett | Nurse Practitioner | 194 Ne Hancock Ave, Madison, FL 32340-2546 | 2016-08-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376016980 | Annie Laura Dyke | Registered Nurse | 213 Sw Third Ave, Madison, FL 32340 | 2019-01-07 |
| 1730698051 | Judith Khristian Sever-johnson | Registered Nurse | 218 Sw Third Avenue, Madison, FL 32340 | 2017-09-29 |
| 1265800437 | Maria Anchondo | Dentist | Ave. De La Raza #4722, Suite 3, Juarez, CHIHUAHUA 32340 | 2015-09-04 |
| 1508106063 | Family First Wellness Clinic, LLC | Family Medicine | 486 Sw Rutledge Street, Madison, FL 32340 | 2013-02-20 |
| 1306032073 | North Florida Pharmacy of Madison Inc. | Durable Medical Equipment & Medical Supplies | 139 Sw Macon St, Madison, FL 32340 | 2007-09-17 |
| 1295949444 | Roderick K Shaw IIi Dmd Pa | Dentist | 255 Ne Duval Ave, Madison, FL 32340 | 2007-05-09 |
| 1124159728 | Duramed Medical Services | Physiological Laboratory | 289 Sw Range Ave, Ste D, Madison, FL 32340 | 2007-03-08 |
| 1861595514 | Holiday Cvs LLC | Durable Medical Equipment & Medical Supplies | 407 East Base St, Madison, FL 32340 | 2006-09-07 |
| 1194701862 | Mos LLC | Nurse Practitioner | 256 Sw Washington Ave, Madison, FL 32340 | 2005-12-15 |
| 1699248203 | Katelynn Mae Croft | Licensed Practical Nurse | 213 Sw Third Ave, Madison, FL 32340 | 2019-01-07 |
| Find all providers in zip 32340 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
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|---|---|---|---|---|
| 1558627158 | Valleyfamily Care | Clinic/Center | 12060 County Line Rd Ste D, Madison, AL 35756-2004 | 2012-04-09 |
| 1801039565 | Boone Memorial Hospital, Inc | Clinic/Center | 660a S Main St, Madison, WV 25130-1245 | 2009-04-10 |
| 1609874338 | Madison Memorial Healthcare Clinic | Clinic/Center | 201 E Marion St, Madison, FL 32340-2525 | 2005-07-07 |
| 1891792917 | Madison County Hospital Health Systems Inc | Clinic/Center | 235 Sw Dade St, Madison, FL 32340-2363 | 2005-07-05 |
| 1558648311 | Valley Family Care | Clinic/Center | 12060 County Line Rd, Suite D, Madison, AL 35756-2003 | 2011-11-08 |
| 1144266156 | Lac Qui Parle Clinic of Madison, Inc | Clinic/Center | 820 3rd Ave, Madison, MN 56256-1014 | 2006-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952917015 | Bonifay Rural Health Cinic | Clinic/Center | 2910 Hospital Dr Ste A, Bonifay, FL 32425-4268 | 2020-09-23 |
| 1013540947 | Clark Clinic Inc | Clinic/Center | 12620 Curley St, San Antonio, FL 33576-8136 | 2020-02-19 |
| 1023506532 | Sacred Heart Hospital On The Gulf | Clinic/Center | 805 Highway 22, Wewahitchka, FL 32465-3237 | 2018-04-30 |
| 1639693492 | Clark Clinic Inc | Clinic/Center | 910 W Myers Blvd, Mascotte, FL 34753-9748 | 2017-08-02 |
| 1194173419 | Holmes County Hospital Corporation | Clinic/Center | 5556 Brown St, Graceville, FL 32440-1007 | 2016-05-26 |
| 1568826873 | Healthvine Medical Group Inc | Clinic/Center | 725 Benton Ave, Brooksville, FL 34601-3213 | 2016-04-12 |
| 1164808465 | Family and After Hours Care, LLC | Clinic/Center | 1413 Nw 23rd Ave, Chiefland, FL 32626 | 2015-08-10 |
| 1891171914 | High Springs Pediatrics LLC. | Clinic/Center | 14900 Nw 140th St, Alachua, FL 32615-6276 | 2015-07-31 |
| 1982963344 | Sacred Heart Hospital On The Gulf | Clinic/Center | 55 Avenue 'e', Apalachicola, FL 32320-1763 | 2012-05-04 |
| 1760776900 | Sonnis Pediatrics, Inc. | Clinic/Center | 1125 S 6th Ave, Wauchula, FL 33873-3350 | 2011-06-06 |
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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.