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ETTIENNE'S PREMIER PEDIATRIC CARE LLC
NPI 1841408697
Pediatrics in Bowie, MD

Active since May 17, 2007CLIA 21D0963328 · Waiver
2905 MITCHELLVILLE RD, STE 115, BOWIE, MD 20716(301) 390-7960(301) 218-2800 Get Directions Write a Review

NPPES record last updated: December 12, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ettienne's Premier Pediatric Care Llc NPPES

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

ETTIENNE'S PREMIER PEDIATRIC CARE LLC (NPI 1841408697) is a healthcare organization registered as a pediatrics in Bowie, Maryland and active in the NPI registry since May 2007. The organization holds a CLIA Waiver certificate valid through July 26, 2027 and lists Suzette Scipio Ettienne, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1841408697
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameETTIENNE'S PREMIER PEDIATRIC CARE LLC
Location Address2905 MITCHELLVILLE RD, STE 115Bowie, MD 20716-1385
Mailing Address2905 Mitchellville Rd, Ste 115Bowie, MD 20716-1385 · (301) 390-7960 · Fax (301) 218-2800
Phone(301) 390-7960
Fax(301) 218-2800
Organization SubpartNo
Authorized OfficialSuzette Scipio EttienneMedical Director · (301) 390-7960
Enumeration DateMay 17, 2007
Last NPPES UpdateDecember 12, 2013
✔ NPI 1841408697 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in MD · D0046373
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.
2905 MITCHELLVILLE RD, Bowie, MD 20716
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Other Identifiers 1

Medicaid363101000MD

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

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 21D0963328

Ettienne's Premier Pediatric Care LLC · Bowie, MD
Active · expires Jul 26, 2027
CLIA Number21D0963328
Laboratory TypePhysician Office
Certificate Effective DateJuly 27, 2025
Certificate Expiration DateJuly 26, 2027
Laboratory DirectorSuzette R. Scipio Ettienne MD
Laboratory Phone(301) 390-7960
Laboratory LocationEttienne's Premier Pediatric Care LLC2905 Mitchellville Road Suite 115, Bowie, MD 20716
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 15

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

JAYASREE STEWART
Social Worker
2905 MITCHELLVILLE RD
BOWIE, MD 20716
Prince George's County (301) 701-6965
EDUARDO VARGAS DDS MS PC
Dentist
2905 MITCHELLVILLE RD, SUITE 109
BOWIE, MD 20716
Prince George's County (301) 390-9772
DR. MEENA SOMANCHI PHD, LDN
Nutritionist
2905 MITCHELLVILLE RD, 102
BOWIE, MD 20716
Prince George's County (301) 218-4101
DR. NORMAN COURTNEY SMITH M.D.
Internal Medicine
2905 MITCHELLVILLE RD, SUITE 104
BOWIE, MD 20716
Prince George's County (301) 218-3884
IN STEP PODIATRY CENTER, LLC
Podiatrist (Foot & Ankle Surgery)
2905 MITCHELLVILLE RD, SUITE 105
BOWIE, MD 20716
Prince George's County (301) 430-0337
METRO AREA CHIROPRACTIC & REHAB
Chiropractor
2905 MITCHELLVILLE RD, SUITE 116
BOWIE, MD 20716
Prince George's County (301) 575-6549
PRIMARY CARE PHYSICIANS LLC
Internal Medicine
2905 MITCHELLVILLE RD, SUITE104
BOWIE, MD 20716
Prince George's County (301) 218-3884
LUZ FRANCOIS LCPC
Counselor (Professional)
2905 MITCHELLVILLE RD, UNIT 201
BOWIE, MD 20716
Prince George's County (443) 758-0333

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 Ettienne's Premier Pediatric Care LLC's NPI number?

The NPI number for Ettienne's Premier Pediatric Care LLC is 1841408697. It was assigned to this organization in the NPPES registry on May 17, 2007.

Where is Ettienne's Premier Pediatric Care LLC located?

Ettienne's Premier Pediatric Care LLC is located at 2905 Mitchellville Rd Ste 115, Bowie, MD 20716. The listed phone number is (301) 390-7960.

What is Ettienne's Premier Pediatric Care LLC's specialty?

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

Does Ettienne's Premier Pediatric Care LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 21D0963328) is associated with this NPI, valid through July 26, 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 Ettienne's Premier Pediatric Care LLC was last updated on December 12, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.