BLUEGRASS PEDIATRICS, LLC
NPI 1427478700
Pediatrics in Paducah, KY

Q: What is Bluegrass Pediatrics, LLC's NPI number?

The NPI number for Bluegrass Pediatrics, LLC is 1427478700. It was assigned to this organization in the NPPES registry on April 24, 2014.

Q: What is Bluegrass Pediatrics, LLC's specialty?

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

Active since April 24, 2014

242 BERGER RD, PADUCAH, KY 42003(270) 366-0960(270) 554-1108 Get Directions Write a Review

NPPES record last updated: October 15, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Oct 8, 2019, Feb 14, 2018, Sep 18, 2017 and 1 more (4 updates tracked since 2017).

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About Bluegrass Pediatrics, Llc NPPES

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

BLUEGRASS PEDIATRICS, LLC (NPI 1427478700) is a healthcare organization registered as a pediatrics in Paducah, Kentucky and active in the NPI registry since April 2014. The organization lists Trudy Quertermous, Credentialing/billing Manager, as its authorized official.

NPPES Registry Identity

NPI1427478700

Entity TypeOrganization

Primary Taxonomy208000000X

Legal Business NameBLUEGRASS PEDIATRICS, LLC

Location Address242 BERGER RDPaducah, KY 42003

Mailing Address242 Berger RdPaducah, KY 42003-4522 · (270) 366-0960 · Fax (270) 554-1108

Phone(270) 366-0960

Fax(270) 554-1108

Organization SubpartNo

Authorized OfficialTrudy QuertermousCredentialing/billing Manager · (270) 366-0960

Enumeration DateApril 24, 2014

Last NPPES UpdateOctober 15, 20244 updates tracked since enumeration

NPPES CertifiedSeptember 27, 2024

✔ NPI 1427478700 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

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 ListedNurse PractitionerTaxonomy 363L00000X

242 BERGER RD, Paducah, KY 42003

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Other Identifiers 7

Medicaid7100304720KY

Medicaid7100886900KY

Other1164425831KY · Npi Roach

Other1417671041Npi Felts

Other1427478700KY · Npi Group

Medicaid64095565KY

Medicaid7100483540KY

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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 18D2080529

Bluegrass Pediatrics, PLLC · Paducah, KY

Expired · Jul 8, 2026

CLIA Number18D2080529

Laboratory TypePhysician Office

Certificate Effective DateJuly 9, 2024

Certificate Expiration DateJuly 8, 2026

Laboratory DirectorDr. John M. Roach

Laboratory Phone(270) 366-0960

Laboratory LocationBluegrass Pediatrics, PLLC242 Berger Road, Paducah, KY 42003

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 7

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

LIFEWORKS AESTHETIC CENTER, PSC

Specialist