COVENANT PEDIATRICS, PLLC
NPI 1659670412
Clinic/Center - Rural Health in Athens, TN

Q: What is Covenant Pediatrics, PLLC's NPI number?

The NPI number for Covenant Pediatrics, PLLC is 1659670412. It was assigned to this organization in the NPPES registry on March 19, 2011.

Q: What is Covenant Pediatrics, PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Active since March 19, 2011

421 OLD RICEVILLE RD STE 2, ATHENS, TN 37303(423) 744-8755(423) 744-8568 Get Directions Write a Review

NPPES record last updated: May 23, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 23, 2022, Mar 7, 2018, Apr 27, 2017 (3 updates tracked since 2017).

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About Covenant Pediatrics, Pllc NPPES

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

COVENANT PEDIATRICS, PLLC (NPI 1659670412) is a healthcare organization registered as a rural health in Athens, Tennessee and active in the NPI registry since March 2011. The organization lists Omer Breeden, Business Manager, as its authorized official.

NPPES Registry Identity

NPI1659670412

Entity TypeOrganization

Primary Taxonomy261QR1300X

Legal Business NameCOVENANT PEDIATRICS, PLLC

Location Address421 OLD RICEVILLE RD STE 2Athens, TN 37303-3074

Mailing Address421 Old Riceville Rd Ste 2Athens, TN 37303-3074 · (423) 744-8755 · Fax (423) 744-8568

Phone(423) 744-8755

Fax(423) 744-8568

Organization SubpartNo

Authorized OfficialOmer BreedenBusiness Manager · (423) 744-8755

Enumeration DateMarch 19, 2011

Last NPPES UpdateMay 23, 20223 updates tracked since enumeration

NPPES CertifiedMay 23, 2022

✔ NPI 1659670412 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities

Taxonomy Code261QR1300X

License✔ Licensed in TN · MD19704

421 OLD RICEVILLE RD STE 2, Athens, TN 37303

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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 44D0897274

Covenant Pediatrics · Athens, TN

Expired · Jul 24, 2026

CLIA Number44D0897274

Laboratory TypePhysician Office

Certificate Effective DateJuly 25, 2024

Certificate Expiration DateJuly 24, 2026

Laboratory DirectorDr. Kimberly T. Breeden

Laboratory Phone(423) 744-8755

Laboratory LocationCovenant Pediatrics421 Old Riceville Rd Suite 2, Athens, TN 37303

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 6

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

CONSTANCE F COWHERD ANP

Nurse Practitioner (Pediatrics)