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

Kids Care Pediatrics PA

Organization Pediatrics Physician · NPI 1487612628

Kids Care Pediatrics PA is a Pediatrics Physician in Smithfield, North Carolina. Licensed in North Carolina. Registered with an NPI since 2006.

Licensed in
NC
In the registry since
2006
Specialties on file
5
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

101 Kellie Dr
Smithfield, NC 27577-9443
Phone: (919) 938-3749
Fax: (919) 938-3795
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X
Pediatric Adolescent Medicine Physician Taxonomy 2080A0000X
Nurse Practitioner Taxonomy 363L00000X
Family Nurse Practitioner Taxonomy 363LF0000X
Pediatric Nurse Practitioner Taxonomy 363LP0200X · Licence 147337 (NC)

Record details

NPI number1487612628
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Debra Tetreault — President · (919) 938-3749
NPI enumeratedMay 3, 2006
Last updated in NPPESSeptember 23, 2024
Certification dateSeptember 23, 2024
Mailing address101 Kellie Dr, Smithfield, NC 27577-9443

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