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JACKSON PEDIATRICS PC
NPI 1316158272
Pediatrics in Jackson, WY

Active since May 24, 2007CLIA 53D2203437 · Waiver
557 E. BROADWAY, 557 E. BROADWAY, JACKSON, WY 83001(307) 733-4627(307) 733-5184 Get Directions Write a Review

NPPES record last updated: October 24, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jackson Pediatrics Pc NPPES

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

JACKSON PEDIATRICS PC (NPI 1316158272) is a healthcare organization registered as a pediatrics in Jackson, Wyoming and active in the NPI registry since May 2007. The organization holds a CLIA Waiver certificate valid through December 2, 2026 and lists James R Little, Owner, as its authorized official.

NPPES Registry Identity

NPI1316158272
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameJACKSON PEDIATRICS P.C.
Location Address557 E. BROADWAY, 557 E. BROADWAYJackson, WY 83001-8300
Mailing AddressPo Box 1029, 557 E. BroadwayJackson, WY 83001-1029 · (307) 733-4627 · Fax (307) 733-5184
Phone(307) 733-4627
Fax(307) 733-5184
Organization SubpartNo
Authorized OfficialJames R LittleOwner · (307) 733-4627
Enumeration DateMay 24, 2007
Last NPPES UpdateOctober 24, 2013
✔ NPI 1316158272 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in WY · 2242A
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.
557 E. BROADWAY, Jackson, WY 83001
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Other Names 1

Doing Business AsJackson Pediatrics Pc

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 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 53D2203437

Jackson Pediatric Associates LLC · Jackson, WY
Active · expires Dec 2, 2026
CLIA Number53D2203437
Laboratory TypePhysician Office
Certificate Effective DateDecember 3, 2024
Certificate Expiration DateDecember 2, 2026
Laboratory DirectorTravis Riddell
Laboratory Phone(307) 733-4627
Laboratory LocationJackson Pediatric Associates LLC505 E Broadway Ave, Jackson, WY 83001
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. JOANNE SCOTT RN
Registered Nurse
557 E. BROADWAY
JACKSON, WY 83001
Teton County (307) 734-9591

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 Jackson Pediatrics P.C.'s NPI number?

The NPI number for Jackson Pediatrics P.C. is 1316158272. It was assigned to this organization in the NPPES registry on May 24, 2007. The provider is doing business as Jackson Pediatrics PC.

Where is Jackson Pediatrics P.C. located?

Jackson Pediatrics P.C. is located at 557 E. Broadway 557 E. Broadway, Jackson, WY 83001. The listed phone number is (307) 733-4627.

What is Jackson Pediatrics P.C.'s specialty?

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

Does Jackson Pediatrics P.C. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 53D2203437) is associated with this NPI, valid through December 2, 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 Jackson Pediatrics P.C. was last updated on October 24, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.