Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Divinity Pediatric Clinic, PLLC

Organization Primary Care Clinic/Center · NPI 1629741152

Divinity Pediatric Clinic, PLLC is a Primary Care Clinic/Center in Pearl, Mississippi. Registered with an NPI since 2021.

In the registry since
2021
Specialties on file
2
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

200 Riverwind Dr Ste 104
Pearl, MS 39208-5652
Phone: (601) 345-4044
Fax: (601) 510-9334
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Nurse Practitioner (primary) Taxonomy 363LP0200X
Primary Care Clinic/Center Taxonomy 261QP2300X

Record details

NPI number1629741152
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Rekita McCoy — Ceo · (601) 345-4044
NPI enumeratedJuly 29, 2021
Last updated in NPPESSeptember 3, 2022
Certification dateSeptember 3, 2022
Mailing address463 Magnolia Pl, Brandon, MS 39042-8482

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