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LIVING TREE PEDIATRICS, PLLC
NPI 1396102679
Pediatrics in Bentonville, AR

Active since January 18, 2016CLIA 04D2108081 · Waiver
1110 SE 30TH STREET, BENTONVILLE, AR 72712(479) 282-2966(479) 282-2967 Get Directions Write a Review

NPPES record last updated: March 21, 2022. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Mar 16, 2016, Jan 18, 2016 (2 updates tracked since 2016).

About Living Tree Pediatrics, Pllc NPPES

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

LIVING TREE PEDIATRICS, PLLC (NPI 1396102679) is a healthcare organization registered as a pediatrics in Bentonville, Arkansas and active in the NPI registry since January 2016. The organization holds a CLIA Waiver certificate valid through January 27, 2028 and lists Julie Lynette Tate, Co-owner, as its authorized official.

NPPES Registry Identity

NPI1396102679
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameLIVING TREE PEDIATRICS, PLLC
Location Address1110 SE 30TH STREETBentonville, AR 72712-4290
Mailing AddressP.o. Box 2760Bentonville, AR 72712-4290 · (479) 282-2966 · Fax (479) 282-2967
Phone(479) 282-2966
Fax(479) 282-2967
Organization SubpartNo
Authorized OfficialJulie Lynette TateCo-owner · (479) 282-2966
Enumeration DateJanuary 18, 2016
Last NPPES UpdateMarch 21, 20222 updates tracked since enumeration
NPPES CertifiedMarch 21, 2022
✔ NPI 1396102679 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in AR · E7529
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.
1110 SE 30TH STREET, Bentonville, AR 72712
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Other Identifiers 2

Medicaid191183001AR
Medicaid192425001AR

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 Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

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 04D2108081

Living Tree Pediatrics, PLLC · Bentonville, AR
Active · expires Jan 27, 2028
CLIA Number04D2108081
Laboratory TypePhysician Office
Certificate Effective DateJanuary 28, 2026
Certificate Expiration DateJanuary 27, 2028
Laboratory DirectorDr. Jeffrey A. Savage
Laboratory Phone(314) 620-1719
Laboratory LocationLiving Tree Pediatrics, PLLC1110 SE 30th Street, Bentonville, AR 72712
CLIA data matches this NPI record on: Address Name
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 Living Tree Pediatrics, PLLC's NPI number?

The NPI number for Living Tree Pediatrics, PLLC is 1396102679. It was assigned to this organization in the NPPES registry on January 18, 2016.

Where is Living Tree Pediatrics, PLLC located?

Living Tree Pediatrics, PLLC is located at 1110 SE 30th Street, Bentonville, AR 72712. The listed phone number is (479) 282-2966.

What is Living Tree Pediatrics, PLLC's specialty?

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

Does Living Tree Pediatrics, PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 04D2108081) is associated with this NPI, valid through January 27, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Living Tree Pediatrics, PLLC accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and Ambetter from Superior HealthPlan and 2 other insurers list Living Tree Pediatrics, PLLC 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 Living Tree Pediatrics, PLLC was last updated on March 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.