PROVIDENCE PEDIATRICS
NPI 1265575955
Pediatrics in Williamsport, PA

Q: What is Providence Pediatrics, PC's NPI number?

The NPI number for Providence Pediatrics, PC is 1265575955. It was assigned to this organization in the NPPES registry on February 14, 2007. The provider is also known as Providence Pediatrics.

Q: What is Providence Pediatrics, PC's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Active since February 14, 2007CLIA 39D0692381 · Waiver

338 RUSSELL AVENUE, WILLIAMSPORT, PA 17701(570) 326-5720(570) 601-1522 Get Directions Write a Review

NPPES record last updated: January 11, 2011. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Providence Pediatrics NPPES

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

PROVIDENCE PEDIATRICS (NPI 1265575955) is a healthcare organization registered as a pediatrics in Williamsport, Pennsylvania and active in the NPI registry since February 2007. The organization holds a CLIA Waiver certificate valid through November 21, 2026 and lists Joseph Demay, President, as its authorized official.

NPPES Registry Identity

NPI1265575955

Entity TypeOrganization

Primary Taxonomy208000000X

Legal Business NamePROVIDENCE PEDIATRICS, PC

Location Address338 RUSSELL AVENUEWilliamsport, PA 17701

Mailing Address338 Russell AvenueWilliamsport, PA 17701 · (570) 326-5720 · Fax (570) 601-1522

Phone(570) 326-5720

Fax(570) 601-1522

Organization SubpartNo

Authorized OfficialJoseph DemayPresident · (570) 326-5720

Enumeration DateFebruary 14, 2007

Last NPPES UpdateJanuary 11, 2011

✔ NPI 1265575955 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in PA · MD046306-L

Definition

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.

Also ListedPediatrics · Adolescent MedicineTaxonomy 2080A0000X · License MD046306L (PA)

338 RUSSELL AVENUE, Williamsport, PA 17701

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Other Names 1

Other NameProvidence Pediatrics

Other Identifiers 2

Medicaid0012712310004PA

Medicare UPINF17389PA

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 MULTIPLE SINGLE 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 39D0692381

Providence Pediatrics · Williamsport, PA

Active · expires Nov 21, 2026

CLIA Number39D0692381

Laboratory TypePhysician Office

Certificate Effective DateNovember 22, 2024

Certificate Expiration DateNovember 21, 2026

Laboratory DirectorJoseph Demay MD

Laboratory Phone(570) 326-5720

Laboratory LocationProvidence Pediatrics338 Russell Avenue, Williamsport, PA 17701

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 Providence Pediatrics, PC's NPI number?

The NPI number for Providence Pediatrics, PC is 1265575955. It was assigned to this organization in the NPPES registry on February 14, 2007. The provider is also known as Providence Pediatrics.

Where is Providence Pediatrics, PC located?

Providence Pediatrics, PC is located at 338 Russell Avenue, Williamsport, PA 17701. The listed phone number is (570) 326-5720.

What is Providence Pediatrics, PC's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Providence Pediatrics, PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 39D0692381) is associated with this NPI, valid through November 21, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Providence Pediatrics, PC was last updated on January 11, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.