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FAYETTEVILLE CHILDREN'S CLINIC, P.A.
NPI 1730270448
Pediatrics in Fayetteville, NC

Active since September 27, 2006CLIA 34D0245017 · Waiver
1606 MORGANTON RD, FAYETTEVILLE, NC 28305(910) 484-3121(910) 484-9027 Get Directions Write a Review

NPPES record last updated: July 10, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Fayetteville Children's Clinic, P.a. NPPES

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

FAYETTEVILLE CHILDREN'S CLINIC, P.A. (NPI 1730270448) is a healthcare organization registered as a pediatrics in Fayetteville, North Carolina and active in the NPI registry since September 2006. The organization holds a CLIA Waiver certificate valid through June 11, 2028 and lists William Huske Kelly, President, as its authorized official.

NPPES Registry Identity

NPI1730270448
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameFAYETTEVILLE CHILDREN'S CLINIC, P.A.
Location Address1606 MORGANTON RDFayetteville, NC 28305-4738
Mailing AddressPo Box 53127Fayetteville, NC 28305-3127 · (910) 484-3121 · Fax (910) 484-9027
Phone(910) 484-3121
Fax(910) 484-9027
Organization SubpartNo
Authorized OfficialWilliam Huske KellyPresident · (910) 484-3121
Enumeration DateSeptember 27, 2006
Last NPPES UpdateJuly 10, 2013
✔ NPI 1730270448 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in NC · 39028
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.
1606 MORGANTON RD, Fayetteville, NC 28305
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Other Identifiers 2

Other0235GNC · Blue Cross Blue Shield
Medicaid790235GNC

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 Blue Cross and Blue Shield of NC.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 34D0245017

Fayetteville Children's Clinic, PA · Fayetteville, NC
Active · expires Jun 11, 2028
CLIA Number34D0245017
Laboratory TypePhysician Office
Certificate Effective DateJune 12, 2026
Certificate Expiration DateJune 11, 2028
Laboratory DirectorOlga K. Johnson
Laboratory Phone(910) 484-8457
Laboratory LocationFayetteville Children's Clinic, PA1606 Morganton Road, Fayetteville, NC 28305
CLIA data matches this NPI record on: Address Name
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.

HORACE ROBERT LONG M.D.
Pediatrics
1606 MORGANTON RD
FAYETTEVILLE, NC 28305
Cumberland County (910) 484-3121
WILLIAM HUSKE KELLY M.D.
Pediatrics
1606 MORGANTON RD
FAYETTEVILLE, NC 28305
Cumberland County (910) 484-3121
NIVEEN YOUSSEF ISKANDER M.D.
Pediatrics
1606 MORGANTON RD
FAYETTEVILLE, NC 28305
Cumberland County (910) 484-3121
OLGA KHODAKOVA JOHNSON M.D.
Pediatrics
1606 MORGANTON RD
FAYETTEVILLE, NC 28305
Cumberland County (910) 484-3121

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 Fayetteville Children's Clinic, P.A.'s NPI number?

The NPI number for Fayetteville Children's Clinic, P.A. is 1730270448. It was assigned to this organization in the NPPES registry on September 27, 2006.

Where is Fayetteville Children's Clinic, P.A. located?

Fayetteville Children's Clinic, P.A. is located at 1606 Morganton Rd, Fayetteville, NC 28305. The listed phone number is (910) 484-3121.

What is Fayetteville Children's Clinic, P.A.'s specialty?

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

Does Fayetteville Children's Clinic, P.A. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D0245017) is associated with this NPI, valid through June 11, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Fayetteville Children's Clinic, P.A. accept?

Health plans from Blue Cross and Blue Shield of NC list Fayetteville Children's Clinic, P.A. 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 Fayetteville Children's Clinic, P.A. was last updated on July 10, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.