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General NPI Number Information
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NPI Number | 1306024641
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Entity Type | Organization
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Legal Business Name | THE PEDIATRIC CONNECTION, INC.
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Dates
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Enumeration Date | 02/08/2008
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 100 GATEWAY CENTRE PARKWAY, SUITE 108
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23235-5174
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Country | US
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Telephone | 804-200-6250
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Fax | 855-602-1010
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Provider Business Mailing Address
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Address Line | 400 INTERSTATE NORTH PKWY SE STE 1600
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City | ATLANTA
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State | GA
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Zip | 30339-5047
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Country | US
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Telephone | 470-464-8000
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | MATTHEW BUCKHALTER
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Credential |
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Telephone | 470-464-8000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP0200X
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Taxonomy Name | Pediatric Registered Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number | 0206009101
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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