OrganizationActive
Parkside Pediatric Clinic,p.c.
NPI 1477781169 · Pediatrics Physician · Jackson, MI
Parkside Pediatric Clinic,p.c. is a Pediatrics Physician organization in Jackson, MI (NPI 1477781169).
Provider details
- NPI number
- 1477781169
- Entity type
- Organization
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Katikineni Rao, President(517) 787-4332
- License
- 4301 031905 (MI)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(85/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 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
2100 4th St
Jackson, MI 49203-4518
Phone: (517) 787-4332
Fax: (517) 787-4861
Street-level locationGet directions
Mailing address
2100 4th St
Jackson, MI 49203-4518
Registry dates
- Enumerated
- 2009-07-01
- Last updated
- 2009-07-01
Frequently asked questions
- What is Parkside Pediatric Clinic,p.c.'s NPI number?
- Parkside Pediatric Clinic,p.c.'s National Provider Identifier (NPI) is 1477781169, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Parkside Pediatric Clinic,p.c.?
- Parkside Pediatric Clinic,p.c. is classified in the NPPES registry as Pediatrics Physician (Allopathic & Osteopathic Physicians).
- Where is Parkside Pediatric Clinic,p.c. located?
- Parkside Pediatric Clinic,p.c.'s practice location on file with NPPES is 2100 4th St, Jackson, MI 49203-4518.
- What is Parkside Pediatric Clinic,p.c.'s phone number?
- The practice phone number listed in the NPPES registry for Parkside Pediatric Clinic,p.c. is (517) 787-4332.
- Who is the authorized official for Parkside Pediatric Clinic,p.c.?
- The authorized official listed on Parkside Pediatric Clinic,p.c.'s NPPES record is Katikineni Rao, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Parkside Pediatric Clinic,p.c.'s NPI active?
- Yes — Parkside Pediatric Clinic,p.c.'s NPI (1477781169) is active in the NPPES registry as of the last update on 2009-07-01.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.