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

Lively Pediatrics, PLLC

Organization Pediatrics Physician · NPI 1063006047

Lively Pediatrics, PLLC is a Pediatrics Physician in Princeton, West Virginia. Registered with an NPI since 2021.

In the registry since
2021
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

608 New Hope Rd Ste 7
Princeton, WV 24740-2287
Phone: (304) 913-3160
Fax: (855) 618-2212
Show map & directions

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

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X

Record details

NPI number1063006047
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ryan Mitchell — Office Manager · (304) 952-2087
NPI enumeratedFebruary 21, 2021
Last updated in NPPESMay 10, 2021
Certification dateMay 10, 2021
Mailing address608 New Hope Rd Ste 7, Princeton, WV 24740-2287

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