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SOUTHERN PEDIATRIC CLINIC
NPI 1487766804
Pediatrics in Alexandria, LA

Active since August 31, 2006
1416 METRO DR, ALEXANDRIA, LA 71301(318) 561-4200(318) 561-4205 Get Directions Write a Review

NPPES record last updated: November 3, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Southern Pediatric Clinic NPPES

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

SOUTHERN PEDIATRIC CLINIC (NPI 1487766804) is a healthcare organization registered as a pediatrics in Alexandria, Louisiana and active in the NPI registry since August 2006. The organization lists Stella Immanuel, Owner, as its authorized official.

NPPES Registry Identity

NPI1487766804
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameSOUTHERN PEDIATRIC CLINIC
Location Address1416 METRO DRAlexandria, LA 71301-3424
Mailing Address5910 Dublin RdAlexandria, LA 71303-5234 · (318) 561-4200 · Fax (318) 561-4205
Phone(318) 561-4200
Fax(318) 561-4205
Organization SubpartNo
Authorized OfficialStella ImmanuelOwner · (318) 730-9760
Enumeration DateAugust 31, 2006
Last NPPES UpdateNovember 3, 2015
✔ NPI 1487766804 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ 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.
1416 METRO DR, Alexandria, LA 71301
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Other Identifiers 1

Medicaid1449237LA

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

Other Providers at the Same Location NPPES 3

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

JORDAN MUSGROVE BCBA, LBA
Behavior Analyst
1416 METRO DR
ALEXANDRIA, LA 71301
Rapides Parish (318) 319-7273
JESSICA GARDNER
Nurse Practitioner (Pediatrics)
1416 METRO DR
ALEXANDRIA, LA 71301
Rapides Parish (318) 561-4200
REAGAN KOURY MERRIMAN BCBA, LBA
Behavior Analyst
1416 METRO DR
ALEXANDRIA, LA 71301
Rapides Parish (318) 319-7273

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 Southern Pediatric Clinic's NPI number?

The NPI number for Southern Pediatric Clinic is 1487766804. It was assigned to this organization in the NPPES registry on August 31, 2006.

Where is Southern Pediatric Clinic located?

Southern Pediatric Clinic is located at 1416 Metro Dr, Alexandria, LA 71301. The listed phone number is (318) 561-4200.

What is Southern Pediatric Clinic's specialty?

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

When was this NPI record last updated?

The NPPES record for Southern Pediatric Clinic was last updated on November 3, 2015. 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.