NPIMap

Organization Active NPI

Cereal City Pediatrics

  • Pediatrics Physician
  • Battle Creek, MI
National Provider Identifier
1033155692
Registry record updated Sep 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
CEREAL CITY PEDIATRICS
Practice address
2545 Capital Ave SW
Battle Creek, MI 49015-7120
Phone
(269) 969-8723
Fax
(269) 969-8724
NPI assigned
Jun 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2008

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

Authorized official

Name
Mrs. Diane Thomas
Title
Office Manager
Phone
(269) 969-8723

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

2545 Capital Ave SW
Battle Creek, MI 49015-7120

Mailing address

2545 Capital Ave S.W.
Battle Creek, MI 49015
Phone (269) 969-8723

Other identifiers 1

IdentifierTypeStateIssuer
350A349860OtherMIBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

4520 Beckley Rd
Battle Creek, MI 49015
Phone (269) 969-8723

2545 Capital Ave SW
Battle Creek, MI 49015
Phone (269) 968-4366

Practitioners & affiliated clinicians

Practitioners 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222214400000",
    "number": "1033155692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2545 CAPITAL AVE S.W.",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "49015",
            "telephone_number": "269-969-8723",
            "fax_number": "269-969-8724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2545 CAPITAL AVE SW",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490157120",
            "telephone_number": "269-969-8723",
            "fax_number": "269-969-8724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEREAL CITY PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2008-09-24",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "269-969-8723",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "350A349860",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Battle Creek, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2008; 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.