NPIMap

Organization Active NPI

Pediatric Associates, P.C.

  • Specialist
  • Dyersburg, TN
National Provider Identifier
1023024874
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
PEDIATRIC ASSOCIATES, P.C.
Practice address
1501 Brayton Ave
Dyersburg, TN 38024-3158
Phone
(731) 285-4111
Fax
(731) 285-4221
NPI assigned
Aug 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Paige Davis
Title
Office Manager
Phone
(731) 285-4111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

1501 Brayton Ave
Dyersburg, TN 38024-3158

Mailing address

1501 Brayton Ave
Dyersburg, TN 38024-3158
Phone (731) 285-4111

National Provider Directory

National Provider Directory

Locations

1501 Brayton Ave
Dyersburg, TN 38024
Phone (731) 285-4111

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023024874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 BRAYTON AVE",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380243158",
            "telephone_number": "731-285-4111",
            "fax_number": "731-285-4221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 BRAYTON AVE",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380243158",
            "telephone_number": "731-285-4111",
            "fax_number": "731-285-4221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "PAIGE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "731-285-4111"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dyersburg, TN

Sources for this page

  • 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.