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COLLIERVILLE PEDIATRICS, LLC
NPI 1326229345
Pediatrics in Collierville, TN

Active since November 19, 2007CLIA 44D1076668 · Waiver
2028 W POPLAR AVE, SUITE 112, COLLIERVILLE, TN 38017(901) 854-5455(901) 377-7309 Get Directions Write a Review

NPPES record last updated: November 19, 2007. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Collierville Pediatrics, Llc NPPES

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

COLLIERVILLE PEDIATRICS, LLC (NPI 1326229345) is a healthcare organization registered as a pediatrics in Collierville, Tennessee and active in the NPI registry since November 2007. The organization holds a CLIA Waiver certificate valid through November 18, 2027 and lists Jaya Venkataraman, Md/president, as its authorized official.

NPPES Registry Identity

NPI1326229345
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameCOLLIERVILLE PEDIATRICS, LLC
Location Address2028 W POPLAR AVE, SUITE 112Collierville, TN 38017-0618
Mailing Address2028 W Poplar Ave, Suite 112Collierville, TN 38017-0618 · (901) 854-5455 · Fax (901) 377-7309
Phone(901) 854-5455
Fax(901) 377-7309
Organization SubpartNo
Authorized OfficialJaya VenkataramanMd/president · (901) 854-5455
Enumeration DateNovember 19, 2007
✔ NPI 1326229345 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in TN · 38751
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.
2028 W POPLAR AVE, Collierville, TN 38017
Open in Google Maps ↗

Other Identifiers 1

Medicare UPINF99456TN

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cigna Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Collierville Pediatrics, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

5

Medicare enrollment records show 5 clinicians reassign Medicare billing to Collierville Pediatrics, LLC, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (5)

Kimberly Randolph, APN
Nurse Practitioner
NPI 1144544982
3180 PROFESSIONAL PLZ STE 111
Germantown, TN 38138
(901) 854-5455
✔ PECOS✔ Accepts Medicare1.6 mi
Jaya Venkataraman, MD
Pediatric Medicine
NPI 1487654752
3180 PROFESSIONAL PLAZA SUITE 111
Germantown, TN 38138
(901) 854-5455
✔ PECOS1.6 mi
William Lofton, M.D.
Internal Medicine
NPI 1114927969
1030 JEFFERSON AVE
Memphis, TN 38104
(015) 238-9909
✔ PECOS18 mi
Sania Sayani, MD
Family Practice
NPI 1528528809
404 S BRADLEY ST
Warren, AR 71671
(870) 226-3731
✔ PECOS✔ Accepts Medicare174 mi
Marie Hennelly, M.D.
Family Practice
NPI 1912393539
401-55 W ALLEGHENY AVENUE
Philadelphia, PA 19133
(215) 291-2500
✔ PECOS✔ Accepts Medicare870 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 44D1076668

Collierville Pediatrics LLC Dba Germantown Pediatric & Family Medicine · Germantown, TN
Active · expires Nov 18, 2027
CLIA Number44D1076668
Laboratory TypePhysician Office
Certificate Effective DateNovember 19, 2025
Certificate Expiration DateNovember 18, 2027
Laboratory DirectorDr. Jaya Venkataraman
Laboratory Phone(901) 854-5455
Laboratory LocationCollierville Pediatrics LLC Dba Germantown Pediatric & Family Medicine3180 Professional Plaza Suite 111, Germantown, TN 38138
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 Collierville Pediatrics, LLC's NPI number?

The NPI number for Collierville Pediatrics, LLC is 1326229345. It was assigned to this organization in the NPPES registry on November 19, 2007.

Where is Collierville Pediatrics, LLC located?

Collierville Pediatrics, LLC is located at 2028 W Poplar Ave Suite 112, Collierville, TN 38017. The listed phone number is (901) 854-5455.

What is Collierville Pediatrics, LLC's specialty?

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

Is Collierville Pediatrics, LLC enrolled in Medicare?

Yes. Collierville Pediatrics, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Collierville Pediatrics, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians reassign their Medicare billing to Collierville Pediatrics, LLC, in Family Practice, Internal Medicine, Nurse Practitioner and Pediatric Medicine. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Collierville Pediatrics, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 44D1076668) is associated with this NPI, valid through November 18, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Collierville Pediatrics, LLC accept?

Health plans from Cigna Healthcare list Collierville Pediatrics, 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 Collierville Pediatrics, LLC was last updated on November 19, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.