PEDIATRIA HEALTHCARE, LLC (NPI# 1770927345) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770927345 |
| Entity Type | Organization |
| Organization Name | PEDIATRIA HEALTHCARE, LLC |
| Other Organization Name | AVEANNA HEALTHCARE |
| Practice Address |
1183 Jacks Run Rd North Versailles PA 15137-0000 |
| Mailing Address |
400 Interstate North Pkwy Se Ste 1600 Atlanta GA 30339-5047 |
| Practice Telephone | 4123496708 |
| Practice Fax Number | 4123496716 |
| Mailing Telephone | 7702488740 |
| Mailing Fax Number | 7702488192 |
| Enumeration Date | 2013-04-25 |
| Last Update Date | 2018-11-30 |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 1021992800016 | 05 |
| 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 |
| 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 |
| 1124296389 | Pediatria Healthcare, LLC | Clinic/Center | 25 Chatham Ctr S, Savannah, GA 31405-1302 | 2008-02-11 |
| Street Address |
1183 JACKS RUN RD |
| City | NORTH VERSAILLES |
| State | PA |
| Zip Code | 15137-0000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841747441 | John Crupie | Pharmacist | 1901 Lincoln Highway, N. Versailles, PA 15137 | 2016-09-01 |
| 1598178055 | Zackary Joseph Zamosky | Specialist/Technologist | 1700 Howell Street, North Versailles, PA 15137 | 2014-06-03 |
| 1346682705 | Umoja With Nia, LLC | Social Worker | 1000 Jacks Run Road, North Versailles, PA 15137 | 2013-07-25 |
| 1518306356 | Jennifer Anne Parco | Registered Nurse | 1183 Jacks Run Road, Pediatria Healthcare for Kids, North Versailles, PA 15137 | 2013-06-14 |
| 1831291129 | Family Home Health Services, Inc D/b/a Three Rivers Hospice | Hospice Care, Community Based | 1195 Jacks Run Road, North Versailles, PA 15137 | 2006-09-05 |
| 1306256508 | Christina Lynn Westbrook | Registered Nurse | 1183 Jacks Run Road, Peadiatria Healthcare for Kids, North Versailles, PA 15137 | 2014-04-28 |
| 1457790966 | Roxanne J Cook | Registered Nurse | 1183 Jacks Run Road, North Versailles, PA 15137 | 2013-06-18 |
| 1831748086 | Vizion Eyecare Services | Eyewear Supplier (Equipment, not the service) | 409 E Carter Dr, North Versailles, PA 15137-1401 | 2019-09-10 |
| 1043363823 | Divine Intervention Group Inc. | Counselor | 90 Port Perry Rd, North Versailles, PA 15137-1436 | 2007-01-18 |
| 1629513569 | Amanda Ludwig | Counselor | 90 Port Perry Rd, North Versailles, PA 15137-1436 | 2017-01-02 |
| Find all providers in zip 15137 | ||||
| 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 |
|---|---|---|---|---|
| 1225656739 | 15 Wesner Lane Pecc Operating Company, Lp | Clinic/Center | 15 Wesner Ln Ste 101, Danville, PA 17821-8023 | 2020-07-10 |
| 1154639847 | Frankies World Foundation | Clinic/Center | 1011 Poplar St, Philadelphia, PA 19123-1962 | 2010-09-16 |
| 1811162639 | Pediatria Healthcare, LLC | Clinic/Center | 353 Markle Dr, Harrisburg, PA 17111-2762 | 2008-04-23 |
| 1235277690 | Lauren's House, LLC | Clinic/Center | 17 Creek Pkwy, Suite 200, Boothwyn, PA 19061-3148 | 2007-02-01 |
| 1699813063 | Lauren's House North Philadelphia, LLC | Clinic/Center | 1318 W Clearfield St, Suite 300, Philadelphia, PA 19132-2423 | 2007-02-01 |
| 1285770917 | Children's Cognitive and Behavioral Health Inc. | Clinic/Center | 211 South St Ste 637, Philadelphia, PA 19147-2305 | 2007-01-29 |
| 1467506626 | Helping Hand Childre's Center | Clinic/Center | 2159 Oregon Pike, Lancaster, PA 17601-4604 | 2007-01-23 |
| 1992041495 | Wonder Kids Medical Daycare | Clinic/Center | 647 E Roseville Rd, Lancaster, PA 17601-4235 | 2013-01-02 |
| 1548557879 | Pediatria Healthcare, LLC | Clinic/Center | 8101 Washington Ln, Suite 102, Wyncote, PA 19095-1625 | 2011-07-07 |
| 1033429279 | Pediatria Healthcare, LLC | Clinic/Center | 1600 Peninsula Dr, 19, Erie, PA 16505-4261 | 2010-10-20 |
| Find all providers with the same taxonomy | ||||
| City | NORTH VERSAILLES |
| Zip Code | 15137 |
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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.