DOTHAN PEDIATRIC CLINIC, P. A. – Pediatrics Physician, NPI 1376508788

DOTHAN PEDIATRIC CLINIC, P. A. is a healthcare provider. based in Dothan, Alabama. specializing in Pediatrics Physician. The NPI Number for DOTHAN PEDIATRIC CLINIC, P. A. is 1376508788

Main info

Organization
Name
DOTHAN PEDIATRIC CLINIC, P. A.
NPI
1376508788
Phone
(334) 793-1881
Address
126 CLINIC DR
Authorized Official
GINA TOLAR INSURANCE & COLLECTION SUPERVISOR
Enumeration Date
19 April 2006
Last Update Date
22 July 2021
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience65
Completeness75
Years active:20State licenses:0Digital endpointsOther names

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Provider Addresses for DOTHAN PEDIATRIC CLINIC, P. A.

  • 126, Clinic Drive, Dothan, Houston County, Alabama, 36303, United States

    DOTHAN, AL 363031980

    Phone: (334) 793-1881

    Fax: (334) 712-1815

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-11-23

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20041123000377OClinic/Group PracticeALTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 36303)

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Reviews

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Frequently asked questions

Can I verify DOTHAN PEDIATRIC CLINIC, P. A. with an NPI only?
You can start verification with NPI 1376508788 for DOTHAN PEDIATRIC CLINIC, P. A., then check state licensing separately.
Does the file indicate DOTHAN PEDIATRIC CLINIC, P. A. is practicing under active NPI?
Directory data currently reports DOTHAN PEDIATRIC CLINIC, P. A. as active.
What taxonomy line describes DOTHAN PEDIATRIC CLINIC, P. A.?
For research purposes, treat DOTHAN PEDIATRIC CLINIC, P. A. as Pediatrics Physician in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for DOTHAN PEDIATRIC CLINIC, P. A.?
DOTHAN PEDIATRIC CLINIC, P. A.'s geographic hint is Dothan, Alabama in our summary view.
What does 'Organization' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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