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WILKES PEDIATRIC CLINIC, PLLC
NPI 1659487502
Pediatrics in North Wilkesboro, NC

Active since August 22, 2006
1925 W PARK DR, NORTH WILKESBORO, NC 28659(336) 903-0147(336) 903-1687 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Wilkes Pediatric Clinic, Pllc NPPES

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

WILKES PEDIATRIC CLINIC, PLLC (NPI 1659487502) is a healthcare organization registered as a pediatrics in North Wilkesboro, North Carolina and active in the NPI registry since August 2006. The organization lists Jackie T Johnson, Practice Manager, as its authorized official.

NPPES Registry Identity

NPI1659487502
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameWILKES PEDIATRIC CLINIC, PLLC
Location Address1925 W PARK DRNorth Wilkesboro, NC 28659-3564
Mailing Address1925 W Park DrNorth Wilkesboro, NC 28659-3564 · (336) 903-0147 · Fax (336) 903-1687
Phone(336) 903-0147
Fax(336) 903-1687
Organization SubpartNo
Authorized OfficialJackie T JohnsonPractice Manager · (336) 903-0096
Enumeration DateAugust 22, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1659487502 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.
1925 W PARK DR, North Wilkesboro, NC 28659
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Other Identifiers 1

Medicaid89013NNNC

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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 for Provider-Performed Microscopy Procedures (PPMP) 34D1002125

Wilkes Pediatric Clinic PLLC · North Wilkesboro, NC
Expired · Jul 29, 2026
CLIA Number34D1002125
Laboratory TypePhysician Office
Certificate Effective DateJuly 30, 2024
Certificate Expiration DateJuly 29, 2026
Laboratory DirectorJoanna W. Van Noy
Laboratory Phone(336) 903-0147
Laboratory LocationWilkes Pediatric Clinic PLLC1925 West Park Dr, North Wilkesboro, NC 28659
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 10

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

DR. KRISTEN MARIE MUMFORD MD
Pediatrics
1925 W PARK DR
NORTH WILKESBORO, NC 28659
Wilkes County (336) 903-0147
DR. JULIE ABRAMS KOCH M.D.
Pediatrics
1925 W PARK DR
NORTH WILKESBORO, NC 28659
Wilkes County (336) 903-0147
RACHEL SHEPHERD MILES PA-C
Physician Assistant
1925 W PARK DR
NORTH WILKESBORO, NC 28659
Wilkes County (336) 903-0147
MRS. JENNIFER E HARTLEY PA-C
Physician Assistant
1925 W PARK DR
NORTH WILKESBORO, NC 28659
Wilkes County (336) 903-0147
GINNA EDWARDS PA-C
Physician Assistant
1925 W PARK DR
NORTH WILKESBORO, NC 28659
Wilkes County (336) 903-0147
DR. TIMOTHY QUINN VAN NOY M.D.
Pediatrics
1925 W PARK DR
NORTH WILKESBORO, NC 28659
Wilkes County (336) 903-0147
SARAH JOHNSON HUFFMAN
Nurse Practitioner (Family)
1925 W PARK DR
N WILKESBORO, NC 28659
Wilkes County (336) 903-0147
MAEGAN MARLOWE GALLIHER DNP
Nurse Practitioner (Family)
1925 W PARK DR
NORTH WILKESBORO, NC 28659
Wilkes County (336) 903-0147

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 Wilkes Pediatric Clinic, PLLC's NPI number?

The NPI number for Wilkes Pediatric Clinic, PLLC is 1659487502. It was assigned to this organization in the NPPES registry on August 22, 2006.

Where is Wilkes Pediatric Clinic, PLLC located?

Wilkes Pediatric Clinic, PLLC is located at 1925 W Park Dr, North Wilkesboro, NC 28659. The listed phone number is (336) 903-0147.

What is Wilkes Pediatric Clinic, PLLC'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 Wilkes Pediatric Clinic, PLLC was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.