NPIMap

Organization Active NPI

Growing Child Pediatrics

  • Pediatrics Physician
  • Knightdale, NC
National Provider Identifier
1013210566
Registry record updated Dec 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
GROWING CHILD PEDIATRICS
Practice address
1005 Big Oak CT
Knightdale, NC 27545-8841
Phone
(919) 266-5669
Fax
(919) 488-1717
NPI assigned
Dec 6, 2010
Last updated
Dec 6, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2010

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

Authorized official

Name
Desi Cuna
Title
Director of Billing
Phone
(919) 488-0015

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NU
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

1005 Big Oak CT
Knightdale, NC 27545-8841

Mailing address

11130 Capital Blvd
Wake Forest, NC 27587-4513
Phone (919) 488-4094

Other identifiers 1

IdentifierTypeStateIssuer
890137QMedicaidNC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D0955704Growing Child Pediatrics at Knightdale1005 Big Oak Court, Knightdale, NC 27545Certificate of waiverJan 17, 2027

National Provider Directory

National Provider Directory
Tax ID family
Growing Child Pediatrics11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1291593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291593600000",
    "number": "1013210566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11130 CAPITAL BLVD",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275874513",
            "telephone_number": "919-488-4094",
            "fax_number": "919-488-4096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 BIG OAK CT",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275458841",
            "telephone_number": "919-266-5669",
            "fax_number": "919-488-1717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROWING CHILD PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-06",
        "last_updated": "2010-12-06",
        "status": "A",
        "authorized_official_last_name": "CUNA",
        "authorized_official_first_name": "DESI",
        "authorized_official_title_or_position": "DIRECTOR OF BILLING",
        "authorized_official_telephone_number": "919-488-0015"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890137Q",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knightdale, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.