KIDS AVENUE PEDIATRICS LLC
NPI 1154092690
Nurse Practitioner in Brandon, MS

Q: What is Kids Avenue Pediatrics LLC's NPI number?

The NPI number for Kids Avenue Pediatrics LLC is 1154092690. It was assigned to this organization in the NPPES registry on September 24, 2021.

Q: What is Kids Avenue Pediatrics LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Active since September 24, 2021

1061 LAKE VILLAGE CIR STE D1, BRANDON, MS 39047(601) 941-0699 Get Directions Write a Review

NPPES record last updated: September 24, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Kids Avenue Pediatrics Llc NPPES

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

KIDS AVENUE PEDIATRICS LLC (NPI 1154092690) is a healthcare organization registered as a nurse practitioner in Brandon, Mississippi and active in the NPI registry since September 2021. The organization lists April Dawn Randle, Administrator, as its authorized official.

NPPES Registry Identity

NPI1154092690

Entity TypeOrganization

Primary Taxonomy363L00000X

Legal Business NameKIDS AVENUE PEDIATRICS LLC

Location Address1061 LAKE VILLAGE CIR STE D1Brandon, MS 39047-6723

Mailing Address1061 Lake Village Cir Ste D1Brandon, MS 39047-6723 · (601) 941-0699

Phone(601) 941-0699

Organization SubpartNo

Authorized OfficialApril Dawn RandleAdministrator · (601) 941-0699

Enumeration DateSeptember 24, 2021

NPPES CertifiedSeptember 23, 2021

✔ NPI 1154092690 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

1061 LAKE VILLAGE CIR STE D1, Brandon, MS 39047

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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

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kids Avenue Pediatrics LLC's NPI number?

The NPI number for Kids Avenue Pediatrics LLC is 1154092690. It was assigned to this organization in the NPPES registry on September 24, 2021.

Where is Kids Avenue Pediatrics LLC located?

Kids Avenue Pediatrics LLC is located at 1061 Lake Village Cir Ste D1, Brandon, MS 39047. The listed phone number is (601) 941-0699.

What is Kids Avenue Pediatrics LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

When was this NPI record last updated?

The NPPES record for Kids Avenue Pediatrics LLC was last updated on September 24, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.