RAINBOW PEDIATRIC PC
NPI 1255474300
Pediatrics in Humboldt, TN

NPI Status: Active since February 15, 2007

Contact Information

1636 E MAIN ST
HUMBOLDT, TN
ZIP 38343
Phone: (731) 784-7833
Fax: (731) 660-8739

NPI Profile Information
Primary Taxonomy
Group Taxonomy
Insurance Plans Accepted
Authorized Official
CLIA Information
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Organization
Pediatrics
Accepts Insurance
CLIA Number: 44D1064076
CLIA Cert. Type: Physician Office
CLIA Exp. Date: 01-28-2027

About RAINBOW PEDIATRIC PC

This page provides the complete NPI Profile along with additional information for Rainbow Pediatric Pc, a pediatrician established in Humboldt, Tennessee operating as a Pediatrics. The healthcare provider is registered in the NPI registry with number 1255474300 assigned on February 2007. The practitioner's primary taxonomy code is 208000000X with license number 41750 (TN). The provider is registered as an organization and their NPI record was last updated 8 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Gina M Dieudonne Md (Owner)

NPI: 1255474300
Provider Name: RAINBOW PEDIATRIC PC
Entity Type: Organization
Location Address: 1636 E MAIN ST HUMBOLDT, TN 38343
Location Phone: (731) 784-7833
Location Fax: (731) 660-8739
Mailing Address: 1636 E MAIN STREET HUMBOLDT, TN 38343
Mailing Phone: (731) 784-7833
Mailing Fax: (731) 660-8739
Is Sole Proprietor?: No
Is Organization Subpart?: No
Enumeration Date: 02-15-2007
Last Update Date: 08-29-2017
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A pediatrician like Rainbow Pediatric Pc is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, 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: Pediatrics
Taxonomy Code: 208000000X
Type: Allopathic & Osteopathic Physicians
License No.: 41750
License State: TN
Taxonomy Description: A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

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.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

BlueCross BlueShield of Tennessee

BlueCross B07S HSA - EPO
BlueCross B15S $0 virtual care from Teladoc Health � - EPO
BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health � - EPO
BlueCross B17S $0 virtual care from Teladoc Health � + Adult Dental - EPO
BlueCross G06S $35 PCP Copay + $0 virtual care from Teladoc Health � - EPO
BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � - EPO
BlueCross S25S $55 PCP Copay + $0 virtual care from Teladoc Health � - EPO
BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health � - EPO
BlueCross S27S $60 PCP Copay + $0 virtual care from Teladoc Health � - EPO
BlueCross S29S $60 PCP Copay + $0 virtual care from Teladoc Health � + Adult Dental - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name: GINA M DIEUDONNE MD
Authorized Official Title: OWNER
Authorized Official Phone: (731) 784-7833

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: 44D1064076
Facility Type: Physician Office
Certificate Effective Date: January 29, 2025
Certificate Expiration Date: January 28, 2027
Laboratory Director: GINA DIEUDONNE MD
Certificate Type: Certificate of Waiver
Certificate Type Description: This CLIA certificate is issued to Rainbow Pediatric Pc 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.

NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1	2	5	5	4	7	4	3	0	0
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	2	10	5	8	7	8	3	0
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 2 + 1 + 0 + 5 + 8 + 7 + 8 + 3 + 0 + 24 = 60
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
									0

The NPI number 1255474300 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.