PEDIATRUST COLUMBUS, LLC (NPI# 1639606940) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639606940 |
| Entity Type | Organization |
| Organization Name | PEDIATRUST COLUMBUS, LLC |
| Practice Address |
306 Hospital Dr Columbus MS 39705-1935 |
| Mailing Address |
2041 Florida Ave Sw Denham Springs LA 70726-4914 |
| Practice Telephone | 6625701957 |
| Practice Fax Number | 6624701035 |
| Mailing Telephone | 2256657287 |
| Mailing Fax Number | 2256657288 |
| Enumeration Date | 2017-05-17 |
| Last Update Date | 2017-05-17 |
| Authorized Official Name | KATHERINE SPARKS CASE (OPERATIONS MANAGER) |
| Authorized Official Telephone | 2256657287 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3140N1450X |
Skilled Nursing Facility Specialization: Nursing Care, Pediatric |
Nursing & Custodial Care Facilities |
| Street Address |
306 HOSPITAL DR |
| City | COLUMBUS |
| State | MS |
| Zip Code | 39705-1935 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639635048 | Caitlin Rose Lesley | Physical Therapist | 306 Hospital Dr, Columbus, MS 39705-1935 | 2019-02-11 |
| 1295786788 | Ameripath Mississippi Inc | Clinical Medical Laboratory | 306 Hospital Dr, Columbus, MS 39705-1935 | 2006-05-12 |
| 1396723599 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 306 Hospital Dr, Columbus, MS 39705-1935 | 2006-01-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255854527 | Kelly Christi Lovelace | Counselor | 428 24th Ave. North, Columbus, MS 39705 | 2017-07-19 |
| 1427505742 | National Vision, Inc. | Technician/Technologist | Bldg 160 Simler Blvd, Columbus, MS 39705 | 2016-09-02 |
| 1093165714 | Holly Murphy | Audiologist | 2430 4th Street North, Columbus, MS 39705 | 2016-06-14 |
| 1275951972 | Oleg Kalsow | Dentist | 300 Hospital Dr Ste 4, Columbus, MS 39705 | 2014-03-31 |
| 1982906509 | Gtrec, Inc. | Optometrist | 1913 Hwy. 45 N., Suite A, Columbus, MS 39705 | 2010-12-02 |
| 1295042919 | Emily Morgan Sesser | Nurse Practitioner | 4508 Hwy 45 N, Columbus, MS 39705 | 2010-09-01 |
| 1528298189 | Matthew Duane Williams | Internal Medicine | 2520 Fifth Street, North, Columbus, MS 39705 | 2009-07-16 |
| 1114156858 | Andrea Nicole Morris | Pediatrics | 2600 Fifth Street North, Columbus, MS 39705 | 2009-07-02 |
| 1124272307 | Paul J Scurti | Internal Medicine | 255 Baptist Blvd Ste 301, Columbus, MS 39705 | 2008-11-13 |
| 1073702171 | Heart To Heart Hospice of Columbus LLC | Hospice Care, Community Based | 2018 Hwy 45 N, Columbus, MS 39705 | 2007-10-15 |
| Find all providers in zip 39705 | ||||
| Taxonomy Code | 3140N1450X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| Specialization | Nursing Care, Pediatric |
| A nursing care facility designed and staffed for the provision of nursing care and appropriate educational and habilitative/rehabilitative services to children with multiple, complex or profound disabilities that can not be cared for in a less restrictive environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093167926 | Marie A Taylor | Skilled Nursing Facility | 3988 Brookshire Ct, Columbus, OH 43227-3670 | 2016-07-03 |
| 1578948543 | Latasha Sarr | Skilled Nursing Facility | 1808 Rankin Ave, Columbus, OH 43219-1124 | 2015-07-20 |
| 1467845347 | Ruth Kinyanjui | Skilled Nursing Facility | 6458 Faircrest Rd, Columbus, OH 43229-2002 | 2015-03-16 |
| 1083049308 | Alimata Oldfield | Skilled Nursing Facility | 3039 Wallcrest Blvd, Columbus, OH 43229 | 2013-09-05 |
| 1245597541 | Okimah Winn | Skilled Nursing Facility | 5395 Refugee Rd, Columbus, OH 43232-4725 | 2012-04-12 |
| 1386939270 | Kila Townsel | Skilled Nursing Facility | 4844 Tamarack Blvd, Columbus, OH 43229-5684 | 2011-06-19 |
| 1144655234 | Roy Oldfield | Skilled Nursing Facility | 3039 Wallcrest Blvd, Columbus, OH 43231-4898 | 2013-09-07 |
| 1114921939 | Karl Hc, LLC | Skilled Nursing Facility | 5700 Karl Rd, Columbus, OH 43229-3602 | 2005-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043858053 | Pediatric Haven | Skilled Nursing Facility | 112 Westfalen Drive, Canton, MS 39046 | 2019-12-20 |
| 1588104814 | Jackson County Pediatric Extended Care LLC | Skilled Nursing Facility | 2025 Jackson Ave, Pascagoula, MS 39567-4427 | 2017-03-06 |
| 1801256318 | Caring Hands Ppec of Vicksburg, LLC | Skilled Nursing Facility | 3419 Wisconsin Ave, Vicksburg, MS 39180-5330 | 2016-02-25 |
| 1538526140 | Desoto Pediatric Extended Care LLC | Skilled Nursing Facility | 750 Stateline Road East, Southhaven, MS 38671 | 2016-01-27 |
| 1609259936 | Meridian Pediatric Extended Care LLC | Skilled Nursing Facility | 3850 Highway 45 N, Meridian, MS 39301-1517 | 2015-07-06 |
| 1093198731 | Caring Hands Prescribed Pediatric | Skilled Nursing Facility | 371 Towne Center Pl, Ridgeland, MS 39157-4833 | 2015-06-30 |
| 1538249792 | Memorial Hospice Inc | Skilled Nursing Facility | 600 Ohio Street, Clarksdale, MS 38614 | 2006-10-16 |
| 1437523511 | Delta Pediatric Care | Skilled Nursing Facility | 526 Fairview Ave, Greenville, MS 38701-5401 | 2015-11-30 |
| 1891107298 | Gulf Coast Pediatric Care LLC | Skilled Nursing Facility | 1285 Spring St, Gulfport, MS 39507-3423 | 2014-05-20 |
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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.