PEDIATRIC ASSOCIATES, P.C.
NPI 1023024874
Specialist in Dyersburg, TN

Q: What is Pediatric Associates, P.C.'s NPI number?

The NPI number for Pediatric Associates, P.C. is 1023024874. It was assigned to this organization in the NPPES registry on August 1, 2006.

Q: What is Pediatric Associates, P.C.'s specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Active since August 01, 2006CLIA 44D0922350 · Certificate of Compliance

1501 BRAYTON AVE, DYERSBURG, TN 38024(731) 285-4111(731) 285-4221 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Pediatric Associates, P.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PEDIATRIC ASSOCIATES, P.C. (NPI 1023024874) is a healthcare organization registered as a specialist in Dyersburg, Tennessee and active in the NPI registry since August 2006. The organization holds a CLIA Certificate of Compliance certificate valid through April 6, 2028 and lists Paige Davis, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1023024874

Entity TypeOrganization

Primary Taxonomy174400000X

Legal Business NamePEDIATRIC ASSOCIATES, P.C.

Location Address1501 BRAYTON AVEDyersburg, TN 38024-3158

Mailing Address1501 Brayton AveDyersburg, TN 38024-3158 · (731) 285-4111 · Fax (731) 285-4221

Phone(731) 285-4111

Fax(731) 285-4221

Organization SubpartNo

Authorized OfficialPaige DavisOffice Manager · (731) 285-4111

Enumeration DateAugust 1, 2006

Last NPPES UpdateAugust 22, 2020

✔ NPI 1023024874 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

Definition

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.

1501 BRAYTON AVE, Dyersburg, TN 38024

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 44D0922350

Pediatric Associates Of West Tennessee, PLLC · Dyersburg, TN

Active · expires Apr 6, 2028

CLIA Number44D0922350

Laboratory TypeRural Health Clinic

Certificate Effective DateApril 7, 2026

Certificate Expiration DateApril 6, 2028

Laboratory DirectorJamie L. Ellerbrook

Laboratory Phone(731) 285-4111

Laboratory LocationPediatric Associates Of West Tennessee, PLLC1501 Brayton Ave, Dyersburg, TN 38024

CLIA data matches this NPI record on: Address Phone

This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GARINE LEPEJIAN M.D.

Specialist