SHINE PEDIATRICS AND WELLNESS CENTER P.A.
NPI 1609110832
Pediatrics in Richardson, TX
NPI Status: Active since November 09, 2012
Contact Information
3600 SHIRE BLVD
SUITE 110
RICHARDSON, TX
ZIP 75082
Phone: (469) 333-1543
Fax: (877) 878-9118
- Organization
- Pediatrics
- CLIA Number: 45D2232281
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 08-10-2025
About SHINE PEDIATRICS AND WELLNESS CENTER P.A.
This page provides the complete NPI Profile along with additional information for Shine Pediatrics And Wellness Center P.a., a pediatrician established in Richardson, Texas operating as a Pediatrics. The healthcare provider is registered in the NPI registry with number 1609110832 assigned on November 2012. The practitioner's primary taxonomy code is 208000000X. The provider is registered as an organization and their NPI record was last updated 4 years ago. Shine Pediatrics And Wellness Center P.a. operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Dr. Randy Naidoo M.d. (President)
- NPI
- 1609110832
- Provider Name
- SHINE PEDIATRICS AND WELLNESS CENTER P.A.
- Entity Type
- Organization
- Location Address
- 3600 SHIRE BLVD SUITE 110 RICHARDSON, TX 75082
- Location Phone
- (469) 333-1543
- Location Fax
- (877) 878-9118
- Mailing Address
- 3600 SHIRE BLVD SUITE 110 RICHARDSON, TX 75082
- Mailing Phone
- (469) 333-1543
- Mailing Fax
- (877) 878-9118
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 11-09-2012
- Last Update Date
- 08-10-2021
- Code Navigator
A pediatrician like Shine Pediatrics And Wellness Center P.a. is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.
Location Map
Secondary Locations
- 5009 Byers Ave
Fort Worth, TX 76107
(469) 333-1543
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pediatrics
- Taxonomy Code
- 208000000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | M0506 (TX) |
| 2 | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | |
| 3 | 2084P0804X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology |
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 45D2232281
- Facility Type
- Physician Office
- Certificate Effective Date
- August 11, 2023
- Certificate Expiration Date
- August 10, 2025
- Laboratory Director
- RANDY NAIDOO
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Shine Pediatrics And Wellness Center P.a. to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 6 | 0 | 9 | 1 | 1 | 0 | 8 | 3 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 6 | 0 | 9 | 2 | 1 | 0 | 8 | 6 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 6 + 0 + 9 + 2 + 1 + 0 + 8 + 6 + 24 = 58 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 58 = 2 | 2 | ||||||||
The NPI number 1609110832 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 5 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1104830033 | DR. RANDY MEL NAIDOO M.D. Individual | Pediatrics | 3600 SHIRE BLVD SUITE 110 RICHARDSON, TX 75082 (469) 333-1543 |
| 1114979796 | DR. MARK LOUIS BAILEY M.D. Individual | Surgery | 3600 SHIRE BLVD STE 104 RICHARDSON, TX 75082 (972) 487-6400 |
| 1376595991 | DR. RUSS DEACON BIRDWELL M.D. Individual | Surgery | 3600 SHIRE BLVD SUITE 104 RICHARDSON, TX 75082 (972) 487-6400 |
| 1346023041 | ADRIAN JONES MS, LPC Individual | Counselor (Professional) | 3600 SHIRE BLVD RICHARDSON, TX 75082 (214) 556-0996 |
| 1720711880 | SHUQUETA THOMAS LMFT Individual | Marriage & Family Therapist | 3600 SHIRE BLVD RICHARDSON, TX 75082 (214) 556-0996 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1609110832, enumerated in the NPI registry as an "organization" on November 09, 2012
The provider is located at 3600 Shire Blvd Suite 110 Richardson, Tx 75082 and the phone number is (469) 333-1543
This medical organization specializes in Pediatrics with taxonomy code 208000000X
The provider's CLIA number is 45D2232281 for a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on November 09, 2012. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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