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SHINING STAR PEDIATRICS
NPI 1952946428
Specialist in Longview, TX

Active since November 08, 2019CLIA 45D2064234 · Waiver
2304 JUDSON RD STE D, LONGVIEW, TX 75605(903) 212-6060(903) 212-4466 Get Directions Write a Review

NPPES record last updated: November 14, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 14, 2019, Nov 8, 2019 (2 updates tracked since 2019).

About Shining Star Pediatrics NPPES

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

SHINING STAR PEDIATRICS (NPI 1952946428) is a healthcare organization registered as a specialist in Longview, Texas and active in the NPI registry since November 2019. The organization holds a CLIA Waiver certificate valid through August 15, 2027, maintains a secondary practice location in Longview, and lists Earlene Cook, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1952946428
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameANCOR HEALTH CENTER, PA
Location Address2304 JUDSON RD STE DLongview, TX 75605-4675
Mailing Address2304 Judson Rd Ste DLongview, TX 75605-4675 · (903) 212-6060 · Fax (903) 212-4466
Phone(903) 212-6060
Fax(903) 212-4466
Organization SubpartYesParent: Ancor Health Center Pa
Authorized OfficialEarlene CookOffice Manager · (903) 985-8110
Enumeration DateNovember 8, 2019
Last NPPES UpdateNovember 14, 20192 updates tracked since enumeration
✔ NPI 1952946428 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
2304 JUDSON RD STE D, Longview, TX 75605
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Other Names 1

Doing Business AsShining Star Pediatrics

Secondary Practice Location 1

Location 12403 Judson Rd Ste DLongview, TX 75605-4639 · Phone (903) 212-6060 · Fax (903) 212-4466

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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 45D2064234

Shining Star Pediatrics · Longview, TX
Active · expires Aug 15, 2027
CLIA Number45D2064234
Laboratory TypePhysician Office
Certificate Effective DateAugust 16, 2025
Certificate Expiration DateAugust 15, 2027
Laboratory DirectorKristi B. Bagnell
Laboratory Phone(903) 212-6060
Laboratory LocationShining Star Pediatrics2304 Judson Road Suite D, Longview, TX 75605
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 2

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

KRISTI B BAGNELL
Pediatrics
2304 JUDSON RD STE D
LONGVIEW, TX 75605
Gregg County (903) 212-6060
DR. KRISTI BENGTSON BAGNELL MD
Pediatrics
2304 JUDSON RD STE D
LONGVIEW, TX 75605
Gregg County (903) 212-6060

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 Ancor Health Center, PA's NPI number?

The NPI number for Ancor Health Center, PA is 1952946428. It was assigned to this organization in the NPPES registry on November 8, 2019. The provider is doing business as Shining Star Pediatrics.

Where is Ancor Health Center, PA located?

Ancor Health Center, PA is located at 2304 Judson Rd Ste D, Longview, TX 75605. The listed phone number is (903) 212-6060.

What is Ancor Health Center, PA's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Does Ancor Health Center, PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2064234) is associated with this NPI, valid through August 15, 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 Ancor Health Center, PA was last updated on November 14, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.