Pediatric Psychiatric Professional LLC
NPI 1811719834ActiveOrganization· Psychiatry & Neurology, Child & Adolescent Psychiatry· Memphis, TN
Psychiatry & Neurology, Child & Adolescent Psychiatry in Memphis, Tennessee, registered in NPPES in October 2024. The authorized official on file is Charles Randale Frith, LCSW, Operations Manager. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1811719834 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 30, 2024 |
| Last updated in NPPES | Oct 30, 2024 |
| Certified by provider | Oct 30, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychiatry & Neurology, Child & Adolescent Psychiatry Primary | 2084P0804X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (TN) |
|---|
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