PEDIATRICS & FAMILY PRACTICE OF COLUMBIA, P.A. – Pediatrics Physician, NPI 1730242462

PEDIATRICS & FAMILY PRACTICE OF COLUMBIA, P.A. is a healthcare provider. based in Columbia, Mississippi. specializing in Pediatrics Physician. The organization holds a License No. 17888 (MS). The NPI Number for PEDIATRICS & FAMILY PRACTICE OF COLUMBIA, P.A. is 1730242462

Main info

Organization
Name
PEDIATRICS & FAMILY PRACTICE OF COLUMBIA, P.A.
NPI
1730242462
Phone
(601) 444-4798
Address
2 W LAKEVIEW DR
Authorized Official
DR. JONATHAN RYOHWAN JANG PRESIDENT MD
Enumeration Date
17 December 2006
Last Update Date
11 October 2011
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience61
Completeness75
Years active:19State licenses:2Digital endpointsOther names

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Provider Addresses for PEDIATRICS & FAMILY PRACTICE OF COLUMBIA, P.A.

  • 2, West Lakeview Drive, Columbia, Marion County, Mississippi, 39429, United States

    SUITE 2

    COLUMBIA, MS 394297960

    Phone: (601) 444-4798

    Fax: (601) 444-5127

    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: 2011-11-22

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2026-04-30 (36 days ago).

Enrollment records

1

Earliest due date

2026-04-30

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
O20111122000661OClinic/Group PracticeMS2026-04-30

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

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 39429)

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Reviews

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Frequently asked questions

What unique ID ties claims to PEDIATRICS & FAMILY PRACTICE OF COLUMBIA, P.A.?
NPI 1730242462 is assigned to PEDIATRICS & FAMILY PRACTICE OF COLUMBIA, P.A. under the national enumeration system.
Is PEDIATRICS & FAMILY PRACTICE OF COLUMBIA, P.A.'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What kind of provider is PEDIATRICS & FAMILY PRACTICE OF COLUMBIA, P.A.?
The page reflects Pediatrics Physician for PEDIATRICS & FAMILY PRACTICE OF COLUMBIA, P.A.. Clinical services aligned with this taxonomy classification.
What location shows for PEDIATRICS & FAMILY PRACTICE OF COLUMBIA, P.A.?
We surface Columbia, Mississippi for PEDIATRICS & FAMILY PRACTICE OF COLUMBIA, P.A. based on available NPPES addresses.
Is PEDIATRICS & FAMILY PRACTICE OF COLUMBIA, P.A. a real provider?
This page reflects official NPPES data for NPI 1730242462. Always confirm identity and privileges with the practice and licensing boards.

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