KIDS CARE PEDIATRICS PA - NPI 1487612628 - Pediatrics in Smithfield, NC

Q: What is Kids Care Pediatrics PA's NPI number?

The NPI number for Kids Care Pediatrics PA is 1487612628. It was assigned to this organization in the NPPES registry on May 3, 2006.

Q: What is Kids Care Pediatrics PA's specialty?

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

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About Kids Care Pediatrics Pa NPPES

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

KIDS CARE PEDIATRICS PA (NPI 1487612628) is a healthcare organization registered as a pediatrics in Smithfield, North Carolina and active in the NPI registry since May 2006. The organization holds a CLIA Waiver certificate valid through September 7, 2027 and lists Debra J Tetreault, President, as its authorized official.

NPPES Registry Identity

NPI1487612628

Entity TypeOrganization

Primary Taxonomy208000000X

Legal Business NameKIDS CARE PEDIATRICS PA

Location Address101 KELLIE DRSmithfield, NC 27577-9443

Mailing Address101 Kellie DrSmithfield, NC 27577-9443 · (919) 938-3749 · Fax (919) 938-3795

Phone(919) 938-3749

Fax(919) 938-3795

Organization SubpartNo

Authorized OfficialDebra J TetreaultPresident · (919) 938-3749

Enumeration DateMay 3, 2006

Last NPPES UpdateSeptember 23, 20242 updates tracked since enumeration

NPPES CertifiedSeptember 23, 2024

✔ NPI 1487612628 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ 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 ListedPediatrics · Adolescent MedicineTaxonomy 2080A0000X

Also ListedNurse PractitionerTaxonomy 363L00000X

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X

Also ListedNurse Practitioner · PediatricsTaxonomy 363LP0200X · License 147337 (NC)

101 KELLIE DR, Smithfield, NC 27577

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Other Identifiers 1

Medicaid8902042NC

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 MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.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 34D1010483

Kids Care Pediatrics · Smithfield, NC

Active · expires Sep 7, 2027

CLIA Number34D1010483

Laboratory TypePhysician Office

Certificate Effective DateSeptember 8, 2025

Certificate Expiration DateSeptember 7, 2027

Laboratory DirectorDebra J. Tetreault

Laboratory Phone(919) 938-3717

Laboratory LocationKids Care Pediatrics101 Kellie Drive, Smithfield, NC 27577

CLIA data matches this NPI record on: Address Name

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

Other Providers at the Same Location NPPES 8

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

MRS. KAREN H MERRITT CPNP

Nurse Practitioner (Pediatrics)