PEDIATRIC SERVICES OF AMERICA, LLC
NPI 1174552665
Nursing Care in Fayetteville, NC

Active since June 30, 2006CLIA 34D0991622 · Waiver
220A N MCPHERSON CH RD, FAYETTEVILLE, NC 28303(910) 323-1811(910) 323-8551 Get Directions Write a Review

NPPES record last updated: January 27, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 1, 2021, Jul 9, 2019, Jan 11, 2016 (3 updates tracked since 2016).

About Pediatric Services Of America, Llc NPPES

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

PEDIATRIC SERVICES OF AMERICA, LLC (NPI 1174552665), doing business as Aveanna Healthcare, is a healthcare organization registered as a nursing care in Fayetteville, North Carolina and active in the NPI registry since June 2006. The organization holds a CLIA Waiver certificate valid through September 24, 2027 and lists Matthew Buckhalter, Cfo, as its authorized official.

NPPES Registry Identity

NPI1174552665
Entity TypeOrganization
Primary Taxonomy251J00000X
Legal Business NamePEDIATRIC SERVICES OF AMERICA, LLC
Location Address220A N MCPHERSON CH RDFayetteville, NC 28303-4495
Mailing Address400 Interstate North Pkwy Se Ste 1600Atlanta, GA 30339-5047 · (470) 464-8000 · Fax (770) 248-8192
Fax(910) 323-8551
Organization SubpartNo
Authorized OfficialMatthew BuckhalterCfo · (470) 464-8000
Enumeration DateJune 30, 2006
Last NPPES UpdateJanuary 27, 20253 updates tracked since enumeration
NPPES CertifiedJanuary 27, 2025
NPI 1174552665 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNursing CareAgencies
Taxonomy Code251J00000X
License Licensed in NC · HC 1542
Definition

A Nursing Care Agency is an entity that provides skilled nursing care through the services of a Registered Nurse (RN) or a Licensed Practical Nurse (LPN), by employees, contracted individuals, or via a registry, in a variety of settings. The agency may engage in providing private duty nursing and/or staffing services.

220A N MCPHERSON CH RD, Fayetteville, NC 28303

Other Names 1

Doing Business AsAveanna Healthcare

Other Identifiers 2

Medicaid7100326NC
Medicaid3408666NC

Accepted Insurance

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 Waiver 34D0991622

Pediatric Services Of America LLC Dba Aveanna Healthcare · Fayetteville, NC
Active · expires Sep 24, 2027
CLIA Number34D0991622
Laboratory TypeHome Health Agency
Certificate Effective DateSeptember 25, 2025
Certificate Expiration DateSeptember 24, 2027
Laboratory DirectorMonica Fyffe
Laboratory Phone(910) 323-1811
Laboratory LocationPediatric Services Of America LLC Dba Aveanna Healthcare220A N Mcpherson Church Rd, Fayetteville, NC 28303
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Pediatric Services Of America, LLC's NPI number?

The NPI number for Pediatric Services Of America, LLC is 1174552665. It was assigned to this organization in the NPPES registry on June 30, 2006. The provider is doing business as Aveanna Healthcare.

Where is Pediatric Services Of America, LLC located?

Pediatric Services Of America, LLC is located at 220A N Mcpherson Ch Rd, Fayetteville, NC 28303. The listed phone number is (910) 323-1811.

What is Pediatric Services Of America, LLC's specialty?

The primary specialty registered for this NPI is Nursing Care with taxonomy code 251J00000X.

Does Pediatric Services Of America, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D0991622) is associated with this NPI, valid through September 24, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Pediatric Services Of America, LLC accept?

Health plans from Blue Cross and Blue Shield of NC list Pediatric Services Of America, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Pediatric Services Of America, LLC was last updated on January 27, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.