KIDS AVENUE PEDIATRICS LLC
NPI 1154092690
Nurse Practitioner in Brandon, MS
NPI Status: Active since September 24, 2021
Contact Information
1061 LAKE VILLAGE CIR STE D1
BRANDON, MS
ZIP 39047
Phone: (601) 941-0699
- Organization
- Nurse Practitioner
- CLIA Number: 25D2247830
- CLIA Cert. Type: Other - NP TEMP TESTING S
- CLIA Exp. Date: 01-09-2026
About KIDS AVENUE PEDIATRICS LLC
This page provides the complete NPI Profile along with additional information for Kids Avenue Pediatrics Llc, a provider established in Brandon, Mississippi operating as a Nurse Practitioner. The healthcare provider is registered in the NPI registry with number 1154092690 assigned on September 2021. The practitioner's primary taxonomy code is 363L00000X. The provider is registered as an organization and their NPI record was last updated 5 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 Dr. April Dawn Randle Fnp (Administrator)
- NPI
- 1154092690
- Provider Name
- KIDS AVENUE PEDIATRICS LLC
- Entity Type
- Organization
- Location Address
- 1061 LAKE VILLAGE CIR STE D1 BRANDON, MS 39047
- Location Phone
- (601) 941-0699
- Mailing Address
- 1061 LAKE VILLAGE CIR STE D1 BRANDON, MS 39047
- Mailing Phone
- (601) 941-0699
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-24-2021
- Last Update Date
- 09-24-2021
- Code Navigator
A nurse practitioner (NP) like Kids Avenue Pediatrics Llc is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.
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
Nurse Practitioner
- Taxonomy Code
- 363L00000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- Taxonomy Description
- (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.
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
- 25D2247830
- Facility Type
- Other - NP TEMP TESTING S
- Certificate Effective Date
- January 10, 2024
- Certificate Expiration Date
- January 09, 2026
- Laboratory Director
- APRIL D. RANDLE
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Kids Avenue Pediatrics Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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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 1154092690, we treat the final digit (0) 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 60. The final step is to find the difference between that total and the next multiple of ten (60 - 60 = 0).
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 60 is 60. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1154092690, enumerated as an "organization" on September 24, 2021.
The provider is located at 1061 LAKE VILLAGE CIR STE D1 BRANDON, MS 39047 and the phone number is (601) 941-0699.
Nurse Practitioner with taxonomy code 363L00000X.
