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DAVIS GROVE PEDIATRICS PLLC
NPI 1457718835
Pediatrics in Cary, NC

Active since January 15, 2016CLIA 34D1104386 · Waiver
204 DAVIS GROVE CIR STE 107, CARY, NC 27519(919) 363-3427(919) 363-3437 Get Directions Write a Review

NPPES record last updated: January 15, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Davis Grove Pediatrics Pllc NPPES

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

DAVIS GROVE PEDIATRICS PLLC (NPI 1457718835) is a healthcare organization registered as a pediatrics in Cary, North Carolina and active in the NPI registry since January 2016. The organization holds a CLIA Waiver certificate valid through September 1, 2027 and lists Jim Yan, Manager, as its authorized official.

NPPES Registry Identity

NPI1457718835
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameDAVIS GROVE PEDIATRICS PLLC
Location Address204 DAVIS GROVE CIR STE 107Cary, NC 27519-2581
Mailing Address204 Davis Grove Cir Ste 107Cary, NC 27519-2581 · (919) 363-3427 · Fax (919) 363-3437
Phone(919) 363-3427
Fax(919) 363-3437
Organization SubpartNo
Authorized OfficialJim YanManager · (919) 452-4761
Enumeration DateJanuary 15, 2016
✔ NPI 1457718835 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in NC · 2008-00550
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.
204 DAVIS GROVE CIR STE 107, Cary, NC 27519
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Other Identifiers 1

Medicaid5910793NC

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 34D1104386

Davis Grove Pediatrics PLLC · Cary, NC
Active · expires Sep 1, 2027
CLIA Number34D1104386
Laboratory TypePhysician Office
Certificate Effective DateSeptember 2, 2025
Certificate Expiration DateSeptember 1, 2027
Laboratory DirectorZhao Min
Laboratory Phone(919) 363-3427
Laboratory LocationDavis Grove Pediatrics PLLC204 Davis Grove Circle Ste 107, Cary, NC 27519
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 Davis Grove Pediatrics PLLC's NPI number?

The NPI number for Davis Grove Pediatrics PLLC is 1457718835. It was assigned to this organization in the NPPES registry on January 15, 2016.

Where is Davis Grove Pediatrics PLLC located?

Davis Grove Pediatrics PLLC is located at 204 Davis Grove Cir Ste 107, Cary, NC 27519. The listed phone number is (919) 363-3427.

What is Davis Grove Pediatrics PLLC's specialty?

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

Does Davis Grove Pediatrics PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D1104386) is associated with this NPI, valid through September 1, 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 Davis Grove Pediatrics PLLC was last updated on January 15, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.