Scottsdale Pediatric Center

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

SCOTTSDALE PEDIATRIC CENTER

Practice address

10200 N 92ND St
Suite 120
Scottsdale, AZ 85258-4534

Phone

(480) 860-1161

Fax

(480) 860-6561

NPI assigned

Apr 6, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Russelle Wallace, M.D.

Title

Physician

Phone

(480) 860-1161

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Richard J Bailey, MD

  • Pediatrics Physician
  • Scottsdale, AZ
  • NPI 1700835931
  NPD (past)
• Jamie Russelle Wallace, MD

  • Pediatrics Physician
  • Scottsdale, AZ
  • NPI 1023066354
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003938283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10200 N 92ND ST",
            "address_2": "SUITE 120",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584534",
            "telephone_number": "480-860-1161",
            "fax_number": "480-860-6561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10200 N 92ND ST",
            "address_2": "SUITE 120",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584534",
            "telephone_number": "480-860-1161",
            "fax_number": "480-860-6561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTTSDALE PEDIATRIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "RUSSELLE",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "480-860-1161",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scottsdale Pain Solutions LLC
• Scottsdale Pathology Associates LTD
• Scottsdale Pathology Consultants, Inc.
• Scottsdale Peaks Family Medicine, PC
• Scottsdale Pediatric Behavioral Services PLLC
• Scottsdale Pediatric Dental Associates Inc
• Scottsdale Perfect Smiles
• Scottsdale Personal OBGYN PLLC
• Scottsdale Physical Medicine & Rehabilitation
• Scottsdale Physical Therapy & Performance

• Pediatrics Physician in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Pediatrics Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.