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PEDIATRUST COLUMBUS, LLC
NPI 1639606940
Skilled Nursing Facility - Nursing Care, Pediatric in Columbus, MS

Active since May 17, 2017CLIA 25D2125572 · Waiver
2213 5TH ST N, COLUMBUS, MS 39705(662) 570-1957(662) 470-1035 Get Directions Write a Review

NPPES record last updated: October 23, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 23, 2023, May 17, 2017 (2 updates tracked since 2017).

About Pediatrust Columbus, Llc NPPES

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

PEDIATRUST COLUMBUS, LLC (NPI 1639606940) is a healthcare organization registered as a nursing care, pediatric in Columbus, Mississippi and active in the NPI registry since May 2017. The organization holds a CLIA Waiver certificate valid through February 8, 2027 and lists Leann Craig, Ceo, as its authorized official.

NPPES Registry Identity

NPI1639606940
Entity TypeOrganization
Primary Taxonomy3140N1450X
Legal Business NamePEDIATRUST COLUMBUS, LLC
Location Address2213 5TH ST NColumbus, MS 39705-2211
Mailing Address6700 Jefferson Highway, Building 12, Ste BBaton Rouge, LA 70806 · (225) 665-6555 · Fax (225) 665-6555
Phone(662) 570-1957
Fax(662) 470-1035
Organization SubpartNo
Authorized OfficialLeann CraigCeo · (225) 252-7633
Enumeration DateMay 17, 2017
Last NPPES UpdateOctober 23, 20232 updates tracked since enumeration
NPPES CertifiedOctober 23, 2023
✔ NPI 1639606940 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySkilled Nursing Facility · Nursing Care, PediatricNursing & Custodial Care Facilities
Taxonomy Code3140N1450X
Definition
A nursing care facility designed and staffed for the provision of nursing care and appropriate educational and habilitative/rehabilitative services to children with multiple, complex or profound disabilities that can not be cared for in a less restrictive environment.
2213 5TH ST N, Columbus, MS 39705
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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 25D2125572

Pediatrust Columbus · Columbus, MS
Active · expires Feb 8, 2027
CLIA Number25D2125572
Laboratory TypePrescr Ped Extended Care
Certificate Effective DateFebruary 9, 2025
Certificate Expiration DateFebruary 8, 2027
Laboratory DirectorJamie Heaton
Laboratory Phone(662) 570-1957
Laboratory LocationPediatrust Columbus306 Hospital Drive, Columbus, MS 39705
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 Pediatrust Columbus, LLC's NPI number?

The NPI number for Pediatrust Columbus, LLC is 1639606940. It was assigned to this organization in the NPPES registry on May 17, 2017.

Where is Pediatrust Columbus, LLC located?

Pediatrust Columbus, LLC is located at 2213 5th St N, Columbus, MS 39705. The listed phone number is (662) 570-1957.

What is Pediatrust Columbus, LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility, specializing in Nursing Care, Pediatric, with taxonomy code 3140N1450X.

Does Pediatrust Columbus, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 25D2125572) is associated with this NPI, valid through February 8, 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 Pediatrust Columbus, LLC was last updated on October 23, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.