SODDY DAISY FAMILY CARE – NPI #1487995304
Pediatrics

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.

SODDY DAISY FAMILY CARE is a provider located in SODDY-DAISY, TN. NPPES has assigned the NPI number 1487995304 to SODDY DAISY FAMILY CARE on March 04, 2013. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The former legal business name for this organization is SODDY DAISY PEDIATRICS. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 208000000X from the Health Care Provider Taxonomy code set, which is classified as Pediatrics.

The NPI profile was previously updated about 9 years ago on May 12, 2017. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SODDY DAISY FAMILY CARE below.

NPI Profile for
SODDY DAISY FAMILY CARE

NPI Number
1487995304
Enumeration Date

(more than 13 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
SODDY DAISY FAMILY CARE
Former Legal Business Name: SODDY DAISY PEDIATRICS
Primary location
9089 DAYTON PIKE
SODDY-DAISY, TN 37379-4313
Phone: (423) 451-0622 Fax: (423) 451-0624
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
SHAHLA KAUKAB
OWNER
Phone: (423) 451-0623
Updated
Identifiers

Identifiers for SODDY DAISY FAMILY CARE

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDTN1509389
MEDICAIDTN1511723
MEDICAIDTN3887638
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
208000000X
- Pediatrics (Primary)
TN 28243
207R00000X
- Internal Medicine
TN 29446

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.