OrganizationActive
Providence Pediatric Practice LLC
NPI 1932160629 · Pediatrics Physician · Media, PA
Providence Pediatric Practice LLC is a Pediatrics Physician organization in Media, PA (NPI 1932160629).
Provider details
- NPI number
- 1932160629
- Entity type
- Organization
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jacquelyn Gibbons, Physician Senior Partner(610) 565-1945
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 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
100 Granite Dr
Suite 200
Media, PA 19063-5134
Phone: (610) 565-1945
Fax: (610) 892-7848
Street-level locationGet directions
Mailing address
100 Granite Dr
Media, PA 19063-5134
Registry dates
- Enumerated
- 2006-03-31
- Last updated
- 2009-03-18
Frequently asked questions
- What is Providence Pediatric Practice LLC's NPI number?
- Providence Pediatric Practice LLC's National Provider Identifier (NPI) is 1932160629, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Providence Pediatric Practice LLC?
- Providence Pediatric Practice LLC is classified in the NPPES registry as Pediatrics Physician (Allopathic & Osteopathic Physicians).
- Where is Providence Pediatric Practice LLC located?
- Providence Pediatric Practice LLC's practice location on file with NPPES is 100 Granite Dr, Media, PA 19063-5134.
- What is Providence Pediatric Practice LLC's phone number?
- The practice phone number listed in the NPPES registry for Providence Pediatric Practice LLC is (610) 565-1945.
- Who is the authorized official for Providence Pediatric Practice LLC?
- The authorized official listed on Providence Pediatric Practice LLC's NPPES record is Jacquelyn Gibbons, Physician Senior Partner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Providence Pediatric Practice LLC's NPI active?
- Yes — Providence Pediatric Practice LLC's NPI (1932160629) is active in the NPPES registry as of the last update on 2009-03-18.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.