St. Jude'S Family and Pediatric Clinic PLLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

ST. JUDE'S FAMILY AND PEDIATRIC CLINIC PLLC

Practice address

5140 Montana Ave
El Paso, TX 79903-4904

Phone

(915) 544-8844

NPI assigned

Nov 26, 2021

Organization subpart

No

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

Authorized official

Name

Annette C Griego, ARNPNPI 1902093016

Title

Ceo

Phone

(915) 544-8844

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Practitioners 2

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

• Annette Griego, NP

  • Family Nurse Practitioner
  • El Paso, TX
  • NPI 1902093016
  Medicare reassignment Authorized official
• Paul M Munoz, D.C.

  • Chiropractor
  • El Paso, TX
  • NPI 1891771572
  Medicare reassignment NPD

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

{
    "created_epoch": "1637884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677715200000",
    "number": "1023775905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5140 MONTANA AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799034904",
            "telephone_number": "915-204-3809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5140 MONTANA AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799034904",
            "telephone_number": "915-544-8844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JUDE'S FAMILY AND PEDIATRIC CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-26",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A",
        "authorized_official_last_name": "GRIEGO",
        "authorized_official_first_name": "ANNETTE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "915-544-8844",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St Giles Nursing and Rehabilitation Center LLC
• St Luke Home Health LLC
• St Teresa Nursing and Rehabilitation Center, LLC
• Maureen Marie St. Almond, M. ED., LPC
• St. Jude International Cancer Associates, P.a.
• Alex St. Louis, OTR
• St. Luke'S Surgical Clinic
• Ryan Lance Staab, FNP-C
• Lilliana Staatz, MSW, LCSW
• Jacqueline Margaret Stagen, CRNA

• Pediatrics Physician in El Paso, TX
• Providers in El Paso, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.