PEDIATRIC ASSOCIATES, P.C.
NPI 1023024874
Specialist in Dyersburg, TN
NPI Status: Active since August 01, 2006
Contact Information
1501 BRAYTON AVE
DYERSBURG, TN
ZIP 38024
Phone: (731) 285-4111
Fax: (731) 285-4221
- Organization
- Specialist
- CLIA Number: 44D0922350
- CLIA Cert. Type: Rural Health Clinic
- CLIA Exp. Date: 04-06-2028
About PEDIATRIC ASSOCIATES, P.C.
This page provides the complete NPI Profile along with additional information for Pediatric Associates, P.c., a provider established in Dyersburg, Tennessee operating as a Specialist. The healthcare provider is registered in the NPI registry with number 1023024874 assigned on August 2006. The practitioner's primary taxonomy code is 174400000X. The provider is registered as an organization and their NPI record was last updated 6 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Paige Davis (Office Manager)
- NPI
- 1023024874
- Provider Name
- PEDIATRIC ASSOCIATES, P.C.
- Entity Type
- Organization
- Location Address
- 1501 BRAYTON AVE DYERSBURG, TN 38024
- Location Phone
- (731) 285-4111
- Location Fax
- (731) 285-4221
- Mailing Address
- 1501 BRAYTON AVE DYERSBURG, TN 38024
- Mailing Phone
- (731) 285-4111
- Mailing Fax
- (731) 285-4221
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 08-01-2006
- Last Update Date
- 08-22-2020
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Specialist
- Taxonomy Code
- 174400000X
- Type
- Other Service Providers
- Taxonomy Description
- An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 44D0922350
- Facility Type
- Rural Health Clinic
- Certificate Effective Date
- April 07, 2026
- Certificate Expiration Date
- April 06, 2028
- Laboratory Director
- JAMIE L. ELLERBROOK
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Pediatric Associates, P.c. after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1023024874, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 56. The final step is to find the difference between that total and the next multiple of ten (60 - 56 = 4).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 56 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 5 providers are registered at the same or a nearby location.
DYERSBURG, TN 38024
DYERSBURG, TN 38024
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1023024874, enumerated as an "organization" on August 01, 2006.
The provider is located at 1501 BRAYTON AVE DYERSBURG, TN 38024 and the phone number is (731) 285-4111.
Specialist with taxonomy code 174400000X.
