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WILLOW TREE PEDIATRICS PC
NPI 1407361108
Pediatrics in Cullman, AL

Active since December 05, 2017CLIA 01D2141616 · Waiver
2108 AL HIGHWAY 157, CULLMAN, AL 35058(256) 735-4632(256) 735-4639 Get Directions Write a Review

NPPES record last updated: March 17, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 17, 2018, Dec 15, 2017, Dec 5, 2017 (3 updates tracked since 2017).

About Willow Tree Pediatrics Pc NPPES

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

WILLOW TREE PEDIATRICS PC (NPI 1407361108) is a healthcare organization registered as a pediatrics in Cullman, Alabama and active in the NPI registry since December 2017. The organization holds a CLIA Waiver certificate valid through December 17, 2027, maintains a secondary practice location in Cullman, and lists Heidi Blair, Provider/owner, as its authorized official.

NPPES Registry Identity

NPI1407361108
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameWILLOW TREE PEDIATRICS PC
Location Address2108 AL HIGHWAY 157Cullman, AL 35058-0656
Mailing Address1641 Edgewood St NwCullman, AL 35055-5739 · (256) 708-6143
Phone(256) 735-4632
Fax(256) 735-4639
Organization SubpartNo
Authorized OfficialHeidi BlairProvider/owner · (256) 708-6143
Enumeration DateDecember 5, 2017
Last NPPES UpdateMarch 17, 20183 updates tracked since enumeration
✔ NPI 1407361108 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in AL · 19923
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.
2108 AL HIGHWAY 157, Cullman, AL 35058
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Secondary Practice Location 1

Location 1409 2nd Ave NWCullman, AL 35055-2877 · Phone (256) 735-4632 · Fax (256) 735-4639

Other Identifiers 1

Medicaid138096AL

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 01D2141616

Willow Tree Pediatrics · Cullman, AL
Active · expires Dec 17, 2027
CLIA Number01D2141616
Laboratory TypePhysician Office
Certificate Effective DateDecember 18, 2025
Certificate Expiration DateDecember 17, 2027
Laboratory DirectorHeidi H. Blair
Laboratory Phone(256) 735-4632
Laboratory LocationWillow Tree Pediatrics1167 County Road 437 Suite B, Cullman, AL 35055
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 Willow Tree Pediatrics PC's NPI number?

The NPI number for Willow Tree Pediatrics PC is 1407361108. It was assigned to this organization in the NPPES registry on December 5, 2017.

Where is Willow Tree Pediatrics PC located?

Willow Tree Pediatrics PC is located at 2108 Al Highway 157, Cullman, AL 35058. The listed phone number is (256) 735-4632.

What is Willow Tree Pediatrics PC's specialty?

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

Does Willow Tree Pediatrics PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 01D2141616) is associated with this NPI, valid through December 17, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Willow Tree Pediatrics PC was last updated on March 17, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.