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PEDIATRIC CENTER OF JACKSON
NPI 1659523876
Pediatrics in Jackson, MI

Active since October 21, 2008CLIA 23D0928528 · Waiver
1418 E MICHIGAN AVE, JACKSON, MI 49202(517) 783-1779(517) 783-1899 Get Directions Write a Review

NPPES record last updated: October 21, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Pediatric Center Of Jackson NPPES

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

PEDIATRIC CENTER OF JACKSON (NPI 1659523876) is a healthcare organization registered as a pediatrics in Jackson, Michigan and active in the NPI registry since October 2008. The organization holds a CLIA Waiver certificate valid through May 19, 2027 and lists Souha S Hakim, Owner, as its authorized official.

NPPES Registry Identity

NPI1659523876
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NamePEDIATRIC CENTER OF JACKSON
Location Address1418 E MICHIGAN AVEJackson, MI 49202-3518
Mailing Address1418 E Michigan AveJackson, MI 49202-3518 · (517) 783-1779 · Fax (517) 783-1899
Phone(517) 783-1779
Fax(517) 783-1899
Organization SubpartNo
Authorized OfficialSouha S HakimOwner · (517) 783-1779
Enumeration DateOctober 21, 2008
✔ NPI 1659523876 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in MI · SS068721
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.
1418 E MICHIGAN AVE, Jackson, MI 49202
Open in Google Maps ↗

Other Identifiers 1

Medicaid104499710MI

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 Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.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 23D0928528

Pediatric Center Of Jackson · Jackson, MI
Active · expires May 19, 2027
CLIA Number23D0928528
Laboratory TypePhysician Office
Certificate Effective DateMay 20, 2025
Certificate Expiration DateMay 19, 2027
Laboratory DirectorSouha S. Sultan Hakim
Laboratory Phone(517) 783-1779
Laboratory LocationPediatric Center Of Jackson1418 E Michigan Avenue, Jackson, MI 49202
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 4

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

EMILY MATTEA DNP
Nurse Practitioner (Pediatrics)
1418 E MICHIGAN AVE
JACKSON, MI 49202
Jackson County (517) 783-1779
EDWARD C ROBLES MD PLLC
Specialist
1418 E MICHIGAN AVE
JACKSON, MI 49202
Jackson County (517) 782-6055
DR. SOUHA S HAKIM M.D.
Pediatrics
1418 E MICHIGAN AVE
JACKSON, MI 49202
Jackson County (517) 783-1779
UMESH VERMA MD
Psychiatry & Neurology (Neurology)
1418 E MICHIGAN AVE
JACKSON, MI 49202
Jackson County (517) 783-5448

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 Pediatric Center Of Jackson's NPI number?

The NPI number for Pediatric Center Of Jackson is 1659523876. It was assigned to this organization in the NPPES registry on October 21, 2008.

Where is Pediatric Center Of Jackson located?

Pediatric Center Of Jackson is located at 1418 E Michigan Ave, Jackson, MI 49202. The listed phone number is (517) 783-1779.

What is Pediatric Center Of Jackson's specialty?

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

Does Pediatric Center Of Jackson hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D0928528) is associated with this NPI, valid through May 19, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Pediatric Center Of Jackson accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Pediatric Center Of Jackson 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 Pediatric Center Of Jackson was last updated on October 21, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.