PEDIATRIC SERVICES OF AMERICA, INC (NPI# 1629000914) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629000914 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC SERVICES OF AMERICA, INC |
| Other Organization Name | AVEANNA HEALTHCARE |
| Practice Address |
126 Integra Breeze Ln Ste 3b Daytona Beach FL 32117-5554 |
| Mailing Address |
400 Interstate North Pkwy Se Ste 1600 Atlanta GA 30339-5047 |
| Practice Telephone | 3863040702 |
| Mailing Telephone | 7702488740 |
| Mailing Fax Number | 7702488192 |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2020-10-06 |
| 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 |
|---|---|---|---|---|---|
| N | 251E00000X | Home Health | Agencies | ||
| Y | 251J00000X | Nursing Care | HHA220370961 | FL | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 680444679 | 05 | |
| FL | 681259796 | 05 | |
| FL | 650786700 | 05 |
| Other Name | Type Code |
|---|---|
| Aveanna Healthcare | Doing Business As Name - Organization |
| PSA Healthcare | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609284546 | Pediatric Services of America, Inc | Nursing Care | 7602 Bridgeport Way W Ste 2b, Lakewood, WA 98499-2415 | 2014-07-23 |
| 1720499932 | Pediatric Services of America, Inc | Nursing Care | 55 Main St Unit 350, Norwich, CT 06360-5760 | 2014-05-12 |
| 1598185498 | Pediatric Services of America, Inc | Home Health | 1316 Nw John Jones Dr, Burleson, TX 76028-8040 | 2014-04-18 |
| 1639467327 | Pediatric Services of America, Inc | Nursing Care | 225 Country Club Dr Ste 240, Stockbridge, GA 30281-7339 | 2011-07-14 |
| 1831493790 | Pediatric Services of America, Inc | Nursing Care | 6316 Saint Andrews Rd, Ste A, Columbia, SC 29212-3168 | 2011-01-06 |
| 1285897025 | Pediatric Services of America, Inc | Nursing Care | 400 Interstate North Pkwy Se Ste 1600, Atlanta, GA 30339-5047 | 2008-07-02 |
| 1891740601 | Pediatric Services of America, Inc | Nursing Care | 18440 Thompson Ct, Suite 108, Tinley Park, IL 60477-5426 | 2006-05-23 |
| 1104215235 | Pediatric Services of America, Inc | Nursing Care | 1115 Elkton Dr, Ste 102, Colorado Springs, CO 80907-8507 | 2015-01-13 |
| 1821410234 | Pediatric Services of America, Inc | Nursing Care | 1544 E 3rd St, Williamsport, PA 17701-5404 | 2014-01-21 |
| 1346556917 | Pediatric Services of America, Inc | Home Health | 3105 Citrus Tower Blvd, Suite A, Clermont, FL 34711-6892 | 2010-08-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | PEDIATRIC SERVICES OF AMERICA, INC. | Six Concourse Parkway, Suite 1100, Atlanta, GA 30328 |
| Colorado Business Entities | PEDIATRIC SERVICES OF AMERICA, INC. | 400 Interstate North Pkwy Se, Ste. 1600, Atlanta, GA 30339-5047 |
| Vermont Business Registrations | PEDIATRIC SERVICES OF AMERICA, INC. | Six Concourse Parkway, S, Atlanta, GA 30328 |
| Oregon Corporations, Companies and Business Names | PEDIATRIC SERVICES OF AMERICA, INC. | 400 Interstate N Pkwy Se Ste 1600, Atlanta, GA 30339 |
| Massachusetts Corporations | PEDIATRIC SERVICES OF AMERICA, INC. | Six Concourse Parkway, Suite 1100, Atlanta, GA 30328 |
| Indiana Business Entities | PEDIATRIC SERVICES OF AMERICA, INC. | 310 Technology Pkwy, Norcross, GA 30092 |
| Street Address |
126 INTEGRA BREEZE LN STE 3B |
| City | DAYTONA BEACH |
| State | FL |
| Zip Code | 32117-5554 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992350409 | Erin Selfridge | Pharmacist | 1500 Beville Rd #300, Daytona Beach, FL 32117 | 2019-08-02 |
| 1881185494 | Wellspring Health, LLC | Chiropractor | 701 Ridgewood Ave, Holly Hills, FL 32117 | 2018-05-21 |
| 1780172791 | L & L Db, LLC | Clinic/Center | 1540 Cornerstone Blvd, Suite 100, Daytona Beach, FL 32117 | 2018-04-25 |
| 1154837789 | Brittany Nikolow | Nurse Practitioner | 1717 N. Clyde Morris, Daytona Beach, FL 32117 | 2017-12-19 |
| 1205356946 | Alejandro Andre Pabon Rodriguez | Nurse Anesthetist, Certified Registered | Florida Hospital Memorial Medical Center, 301 Memorial Medical Parkway, Daytona Beach, FL 32117 | 2017-06-23 |
| 1316492135 | Ann Van Herck | Physical Therapist | 1901 Mason Ave Ste 105, Daytona Beach, FL 32117 | 2016-08-22 |
| 1952784779 | Kathryn Brenna Copley | Nurse Practitioner | 1890 Lpga Blvd., Daytona Beach, FL 32117 | 2015-06-30 |
| 1053719559 | Alicia Graham | Case Manager/Care Coordinator | 1570 Megan Bay Circle, Holly Hill, FL 32117 | 2014-12-15 |
| 1578974440 | Halifax Senior Care Inc | Clinic/Center | 1515 Ridgewood Ave, Suite B, Holly Hill, FL 32117 | 2014-05-14 |
| 1013345883 | Kist Alf, Inc | Assisted Living Facility | 1516 Carmen Avenue, Daytona Beach, FL 32117 | 2013-10-14 |
| Find all providers in zip 32117 | ||||
| Taxonomy Code | 251J00000X |
| Grouping | Agencies |
| Classification | Nursing Care |
| A Nursing Care Agency is an entity that provides skilled nursing care through the services of a Registered Nurse (RN) or a Licensed Practical Nurse (LPN), by employees, contracted individuals, or via a registry, in a variety of settings. The agency may engage in providing private duty nursing and/or staffing services. |
| Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699108795 | Tailor-made Medical Solutions | Nursing Care | 1891 N. Clyde Morris Blvd, Ste 100, Daytona Beach, FL 32117 | 2013-08-13 |
| 1851724199 | Csi Private Duty Services, Inc | Nursing Care | 1116 Pelican Bay Dr, Daytona Beach, FL 32119-1381 | 2013-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124628789 | Nurses Vision 2020, LLC | Nursing Care | 8471 Nw 78th Ct, Tamarac, FL 33321-1618 | 2020-10-31 |
| 1538768171 | Amun- Ra Health Services | Nursing Care | 6446 Tabogi Trl, Wesley Chapel, FL 33545-1360 | 2020-10-24 |
| 1316546971 | Aaim Nursing Agency | Nursing Care | 12952 Sw 133rd Ct Ste B, Miami, FL 33186-6175 | 2020-10-23 |
| 1316544760 | Asz Caring Hearts Inc | Nursing Care | 2800 W Oakland Park Blvd Ste 305, Oakland Park, FL 33311-1309 | 2020-10-07 |
| 1063019693 | Front Porch Nurse Registry LLC | Nursing Care | 1680 Sw Bayshore Blvd Ste 112, Port St Lucie, FL 34984-3518 | 2020-10-06 |
| 1750988895 | Coffee & Grace LLC | Nursing Care | 1821 N Pearl St Ste A, Jacksonville, FL 32206-3663 | 2020-10-01 |
| 1508473745 | Atlantic Care Services Clermont LLC | Nursing Care | 15430 County Road 565a Ste P, Groveland, FL 34736-8243 | 2020-09-30 |
| 1851908388 | Atlantic Care Services Haines City LLC | Nursing Care | 651 E Main St Ste 12, Haines City, FL 33844-4241 | 2020-09-29 |
| 1568079069 | Benevolent Heart LLC | Nursing Care | 13366 Ocean Mist Dr, Jacksonville, FL 32258-5204 | 2020-09-28 |
| 1134732910 | Serenity Love and Care LLC | Nursing Care | 1105 Jordan Park St S, St Petersburg, FL 33712-2126 | 2020-08-31 |
| Find all providers with the same taxonomy | ||||
| City | DAYTONA BEACH |
| Zip Code | 32117 |
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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.