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PEDIATRIC PLACE, LLC
NPI 1750074415
Clinic/Center - Medically Fragile Infants and Children Day Care in Ridgeland, MS

Active since May 30, 2023CLIA 25D2292301 · Waiver
116 MARKETRIDGE DR, RIDGELAND, MS 39157(601) 613-4254 Get Directions Write a Review

NPPES record last updated: May 30, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Pediatric Place, Llc NPPES

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

PEDIATRIC PLACE, LLC (NPI 1750074415) is a healthcare organization registered as a medically fragile infants and children day care in Ridgeland, Mississippi and active in the NPI registry since May 2023. The organization holds a CLIA Waiver certificate valid through October 23, 2027 and lists Carmen M Young, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1750074415
Entity TypeOrganization
Primary Taxonomy261QM3000X
Legal Business NamePEDIATRIC PLACE, LLC
Location Address116 MARKETRIDGE DRRidgeland, MS 39157-6009
Mailing Address116 Marketridge DrRidgeland, MS 39157-6009 · (601) 613-4254
Phone(601) 613-4254
Organization SubpartNo
Authorized OfficialCarmen M YoungExecutive Director · (601) 613-4254
Enumeration DateMay 30, 2023
NPPES CertifiedMay 30, 2023
✔ NPI 1750074415 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Medically Fragile Infants and Children Day CareAmbulatory Health Care Facilities
Taxonomy Code261QM3000X
Definition
An entity, facility, or distinct part of a facility specially equipped and staffed to provide care for medically fragile children with varied and complex care needs (e.g., enteral or parental feeding, ostomy care, respiratory/ventilator care, medications and therapies, etc.).
116 MARKETRIDGE DR, Ridgeland, MS 39157
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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 25D2292301

Pediatric Place LLC · Ridgeland, MS
Active · expires Oct 23, 2027
CLIA Number25D2292301
Laboratory TypePed Prescribed Day Ctr
Certificate Effective DateOctober 24, 2025
Certificate Expiration DateOctober 23, 2027
Laboratory DirectorDr. Jenna Dear
Laboratory Phone(601) 301-2082
Laboratory LocationPediatric Place LLC116 Marketridge Dr, Ridgeland, MS 39157
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 3

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

AUTUMN B TAMOR OTD, OTR/L
Occupational Therapist (Pediatrics)
116 MARKETRIDGE DR
RIDGELAND, MS 39157
Madison County (601) 345-1784
AUTUMN TAMOR
Occupational Therapist (Pediatrics)
116 MARKETRIDGE DR
RIDGELAND, MS 39157
Madison County (601) 345-1784
METRIC LAB SERVICES LLC
Clinical Medical Laboratory
116 MARKETRIDGE DR
RIDGELAND, MS 39157
Madison County (601) 557-0204

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 Place, LLC's NPI number?

The NPI number for Pediatric Place, LLC is 1750074415. It was assigned to this organization in the NPPES registry on May 30, 2023.

Where is Pediatric Place, LLC located?

Pediatric Place, LLC is located at 116 Marketridge Dr, Ridgeland, MS 39157. The listed phone number is (601) 613-4254.

What is Pediatric Place, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Medically Fragile Infants and Children Day Care, with taxonomy code 261QM3000X.

Does Pediatric Place, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 25D2292301) is associated with this NPI, valid through October 23, 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 Pediatric Place, LLC was last updated on May 30, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.