Lively Pediatrics, PLLC
NPI 1063006047 · Pediatrics Physician · Princeton, WV
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Lively Pediatrics, PLLC is a Pediatrics Physician organization in Princeton, WV (NPI 1063006047).
Provider details
- NPI number
- 1063006047
- Entity type
- Organization
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Ryan Mitchell, Office Manager(304) 952-2087
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2021-02-21
- Last updated
- 2021-05-10
- Certified
- 2021-05-10
Frequently asked questions
- What is Lively Pediatrics, PLLC's NPI number?
- Lively Pediatrics, PLLC's National Provider Identifier (NPI) is 1063006047, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Lively Pediatrics, PLLC?
- Lively Pediatrics, PLLC is classified in the NPPES registry as Pediatrics Physician (Allopathic & Osteopathic Physicians).
- Where is Lively Pediatrics, PLLC located?
- Lively Pediatrics, PLLC's practice location on file with NPPES is 608 New Hope Rd Ste 7, Princeton, WV 24740-2287.
- What is Lively Pediatrics, PLLC's phone number?
- The practice phone number listed in the NPPES registry for Lively Pediatrics, PLLC is (304) 913-3160.
- Does Lively Pediatrics, PLLC accept Medicare?
- Lively Pediatrics, PLLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Lively Pediatrics, PLLC?
- The authorized official listed on Lively Pediatrics, PLLC's NPPES record is Ryan Mitchell, Office Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Lively Pediatrics, PLLC's NPI active?
- Yes — Lively Pediatrics, PLLC's NPI (1063006047) is active in the NPPES registry as of the last update on 2021-05-10.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.