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Contact Information

KIDZCARE PEDIATRICS, PC
3115 BORDEAUX PARK DR
FAYETTEVILLE, NC28306
 Phone: 910-307-7337
 Fax: 910-323-4620
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for KIDZCARE PEDIATRICS, PC

NPI Number 1548495914
LBN Legal business name KIDZCARE PEDIATRICS, PC
Authorized official SHANTAE LOCKHART - (CREDENTIALS SPECIALIST)
Entity Organization
Organization subpart 1 No
Enumeration date 05/28/2009
Last updated 08/27/2021 - About 5 years ago
Identifiers
NC Medicaid 5908525
NC Other 016VR BCBS
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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