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KIDZCARE PEDIATRICS, PC
NPI 1972015097
Pediatrics in Wallace, NC

Active since October 30, 2017CLIA 34D2142887 · Waiver
112 MEDICAL VILLAGE DR STE D, WALLACE, NC 28466(910) 665-1437(910) 665-1315 Get Directions Write a Review

NPPES record last updated: October 30, 2017. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Kidzcare Pediatrics, Pc NPPES

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

KIDZCARE PEDIATRICS, PC (NPI 1972015097) is a healthcare organization registered as a pediatrics in Wallace, North Carolina and active in the NPI registry since October 2017. The organization holds a CLIA Waiver certificate valid through January 21, 2028 and lists Shantae Renee Lockhart, Credentialing Specialist, as its authorized official.

NPPES Registry Identity

NPI1972015097
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameKIDZCARE PEDIATRICS, PC
Location Address112 MEDICAL VILLAGE DR STE DWallace, NC 28466-1665
Mailing Address5617 Ramsey StFayetteville, NC 28311-1423 · (910) 483-7337 · Fax (910) 483-0648
Phone(910) 665-1437
Fax(910) 665-1315
Organization SubpartNo
Authorized OfficialShantae Renee LockhartCredentialing Specialist · (910) 483-7337
Enumeration DateOctober 30, 2017
✔ NPI 1972015097 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
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.
112 MEDICAL VILLAGE DR STE D, Wallace, NC 28466
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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

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 34D2142887

Kidzcare Pediatrics, PC · Wallace, NC
Active · expires Jan 21, 2028
CLIA Number34D2142887
Laboratory TypePhysician Office
Certificate Effective DateJanuary 22, 2026
Certificate Expiration DateJanuary 21, 2028
Laboratory DirectorJain C. Ashokkumar
Laboratory Phone(910) 665-1437
Laboratory LocationKidzcare Pediatrics, PC112 Medical Village Drive, Suite D, Wallace, NC 28466
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

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

DR. VICTORIA BAUCOM MATTHEWS FNP
Nurse Practitioner (Family)
112 MEDICAL VILLAGE DR STE D
WALLACE, NC 28466
Duplin County (910) 665-1437

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 Kidzcare Pediatrics, PC's NPI number?

The NPI number for Kidzcare Pediatrics, PC is 1972015097. It was assigned to this organization in the NPPES registry on October 30, 2017.

Where is Kidzcare Pediatrics, PC located?

Kidzcare Pediatrics, PC is located at 112 Medical Village Dr Ste D, Wallace, NC 28466. The listed phone number is (910) 665-1437.

What is Kidzcare Pediatrics, PC's specialty?

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

Does Kidzcare Pediatrics, PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D2142887) is associated with this NPI, valid through January 21, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Kidzcare Pediatrics, PC accept?

Health plans from Blue Cross and Blue Shield of NC list Kidzcare Pediatrics, PC 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 Kidzcare Pediatrics, PC was last updated on October 30, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.