Lively Pediatrics, PLLC
NPI 1063006047ActiveOrganization· Pediatrics· Princeton, WV
Pediatrics in Princeton, West Virginia, registered in NPPES in February 2021. The authorized official on file is Ryan Mitchell, Office Manager. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1063006047 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 21, 2021 |
| Last updated in NPPES | Sep 22, 2026 |
| Certified by provider | Sep 22, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pediatrics Primary | 208000000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (WV) |
|---|
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