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KIDSVILLE PEDIATRICS PROSPER
NPI 1255292785
Pediatrics - Pediatric Critical Care Medicine in Mckinney, TX

Active since November 24, 2025CLIA 45D2332550 · Waiver
1400 N COIT RD STE 1604, MCKINNEY, TX 75071(682) 868-1020 Get Directions Write a Review

NPPES record last updated: November 24, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kidsville Pediatrics Prosper NPPES

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

KIDSVILLE PEDIATRICS PROSPER (NPI 1255292785) is a healthcare organization registered as a pediatric critical care medicine in Mckinney, Texas and active in the NPI registry since November 2025. The organization holds a CLIA Waiver certificate valid through October 20, 2027 and lists Ali Shah, Executive Manager, as its authorized official.

NPPES Registry Identity

NPI1255292785
Entity TypeOrganization
Primary Taxonomy2080P0203X
Legal Business NameKIDSVILLE PEDIATRICS PROSPER
Location Address1400 N COIT RD STE 1604Mckinney, TX 75071-6661
Mailing Address1400 N Coit Rd Ste 1604Mckinney, TX 75071-6661
Phone(682) 868-1020
Organization SubpartNo
Authorized OfficialAli ShahExecutive Manager · (682) 868-1020
Enumeration DateNovember 24, 2025
NPPES CertifiedNovember 24, 2025
✔ NPI 1255292785 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 6

★ Primary SpecialtyPediatrics · Pediatric Critical Care MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080P0203X
Definition
A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists.
Also ListedPediatricsTaxonomy 208000000X
Also ListedRespiratory Therapist, Certified · Pulmonary Function TechnologistTaxonomy 2278P1006X
Also ListedPhysician AssistantTaxonomy 363A00000X
Also ListedNurse Practitioner · PediatricsTaxonomy 363LP0200X
Also ListedNurse Practitioner · Psychiatric/Mental HealthTaxonomy 363LP0808X
1400 N COIT RD STE 1604, Mckinney, TX 75071
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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 Waiver 45D2332550

Kidsville Pediatrics · Mckinney, TX
Active · expires Oct 20, 2027
CLIA Number45D2332550
Laboratory TypePhysician Office
Certificate Effective DateOctober 21, 2025
Certificate Expiration DateOctober 20, 2027
Laboratory DirectorOlivia Boone
Laboratory Phone(682) 868-1020
Laboratory LocationKidsville Pediatrics1400 N Coit Road, Suite 1604, Mckinney, TX 75071
CLIA data matches this NPI record on: Address 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 Kidsville Pediatrics Prosper's NPI number?

The NPI number for Kidsville Pediatrics Prosper is 1255292785. It was assigned to this organization in the NPPES registry on November 24, 2025.

Where is Kidsville Pediatrics Prosper located?

Kidsville Pediatrics Prosper is located at 1400 N Coit Rd Ste 1604, Mckinney, TX 75071. The listed phone number is (682) 868-1020.

What is Kidsville Pediatrics Prosper's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Critical Care Medicine, with taxonomy code 2080P0203X.

Does Kidsville Pediatrics Prosper hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2332550) is associated with this NPI, valid through October 20, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Kidsville Pediatrics Prosper was last updated on November 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.