OWEN PARK PEDIATRICS, PA
NPI 1548424104
Pediatrics in Fayetteville, NC

Q: What is Owen Park Pediatrics, PA's NPI number?

The NPI number for Owen Park Pediatrics, PA is 1548424104. It was assigned to this organization in the NPPES registry on July 14, 2008.

Q: What is Owen Park Pediatrics, PA's specialty?

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

Active since July 14, 2008CLIA 34D1034528 · Waiver

1520 OWEN PARK LN, FAYETTEVILLE, NC 28304(910) 860-3500(910) 485-3507 Get Directions Write a Review

NPPES record last updated: July 14, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Owen Park Pediatrics, Pa NPPES

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

OWEN PARK PEDIATRICS, PA (NPI 1548424104) is a healthcare organization registered as a pediatrics in Fayetteville, North Carolina and active in the NPI registry since July 2008. The organization holds a CLIA Waiver certificate valid through December 5, 2026 and lists Paul O Adholla, Owner, as its authorized official.

NPPES Registry Identity

NPI1548424104

Entity TypeOrganization

Primary Taxonomy208000000X

Legal Business NameOWEN PARK PEDIATRICS, PA

Location Address1520 OWEN PARK LNFayetteville, NC 28304-3454

Mailing Address1520 Owen Park LnFayetteville, NC 28304-3454 · (910) 860-3500 · Fax (910) 485-3507

Phone(910) 860-3500

Fax(910) 485-3507

Organization SubpartNo

Authorized OfficialPaul O AdhollaOwner · (910) 860-3500

Enumeration DateJuly 14, 2008

✔ NPI 1548424104 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.

1520 OWEN PARK LN, Fayetteville, NC 28304

Open in Google Maps ↗

Other Identifiers 1

Medicaid8911931NC

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee.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 34D1034528

Owen Park Pediatrics PA · Fayetteville, NC

Active · expires Dec 5, 2026

CLIA Number34D1034528

Laboratory TypePhysician Office

Certificate Effective DateDecember 6, 2024

Certificate Expiration DateDecember 5, 2026

Laboratory DirectorPaul O. Adholla MD

Laboratory Phone(910) 860-3500

Laboratory LocationOwen Park Pediatrics PA1520 Owen Park Lane, Fayetteville, NC 28304

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 2

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

MR. PAUL ODAK ADHOLLA MD

Pediatrics

1520 OWEN PARK LN
FAYETTEVILLE, NC 28304

Cumberland County (910) 860-3500

KIDZCARE PEDIATRICS, PC

Pediatrics

1520 OWEN PARK LN
FAYETTEVILLE, NC 28304

Cumberland County (910) 860-3500

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 Owen Park Pediatrics, PA's NPI number?

The NPI number for Owen Park Pediatrics, PA is 1548424104. It was assigned to this organization in the NPPES registry on July 14, 2008.

Where is Owen Park Pediatrics, PA located?

Owen Park Pediatrics, PA is located at 1520 Owen Park Ln, Fayetteville, NC 28304. The listed phone number is (910) 860-3500.

What is Owen Park Pediatrics, PA's specialty?

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

Does Owen Park Pediatrics, PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D1034528) is associated with this NPI, valid through December 5, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Owen Park Pediatrics, PA accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina and Ambetter of Tennessee list Owen Park Pediatrics, PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Owen Park Pediatrics, PA was last updated on July 14, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.