Provider Demographics
NPI:1932234788
Name:PEDIATRICS PLUS, INC.
Entity Type:Organization
Organization Name:PEDIATRICS PLUS, INC.
Other - Org Name:PEDS PLUS
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:STEELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-894-4774
Mailing Address - Street 1:PO BOX 903
Mailing Address - Street 2:
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-0903
Mailing Address - Country:US
Mailing Address - Phone:423-894-4774
Mailing Address - Fax:423-894-4775
Practice Address - Street 1:4295 CROMWELL RD
Practice Address - Street 2:STE 206
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-2166
Practice Address - Country:US
Practice Address - Phone:423-894-4774
Practice Address - Fax:423-894-4775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN00446653Medicaid
TN3156781OtherBLUE CROSS BLUE SHEILD
TN00446653Medicaid