Med Peds Associates
Med Peds Associates is a healthcare organization registered as Non-Pharmacy Dispensing Site in Kankakee, IL, holding Type 2 (organization) NPI 1649353970 since 2006. The authorized official on file is Direndia Shackelford, Managed Care Specialist.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1649353970 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Med Peds Associates |
| Other name | <Unavail> |
| Practice address | 375 N WALL ST STE P520, Kankakee, IL, 60901 |
| Phone | 8159330194 |
| Fax | 8159331444 |
| Enumeration date | 2006-10-23 |
| Last updated in NPPES | 2008-09-03 |
Authorized official
| Name | Direndia Shackelford |
|---|---|
| Title | Managed Care Specialist |
| Phone | 8006540889 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 332900000X | Non-Pharmacy Dispensing Site | Primary | 036074737 | IL |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1472505 | Other | — | OTHER ID NUMBER-COMMERCIAL NUMBER |
| 036074737 | Medicaid | IL | — |
Copy-ready billing details
Provider: Med Peds Associates NPI: 1649353970 Taxonomy: 332900000X (Non-Pharmacy Dispensing Site) Address: 375 N WALL ST STE P520, Kankakee, IL, 60901
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1053419119 | Alyce Jackson | Individual | Physical Medicine & Rehabilitation Physician | Kankakee, IL |
| 1275952913 | Ekua Gilbert-Baffoe | Individual | Physical Medicine & Rehabilitation Physician | Kankakee, IL |
| 1962994483 | Marissa Ruebhausen | Individual | Family Nurse Practitioner | Kankakee, IL |
Verify this record
Cross-check NPI 1649353970 against the authoritative CMS record: view Med Peds Associates on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What is a Type 2 NPI?
What type of organization is Med Peds Associates?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2008-09-03.