Lifestages Pediatrics LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

LIFESTAGES PEDIATRICS LLC

Practice address

8080 Old York Rd Ste 207
Elkins Park, PA 19027-1426

Phone

(215) 935-6493

NPI assigned

Oct 1, 2019

Last updated

Oct 1, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Annie Kotto, MDNPI 1871826297

Title

Director/Physician

Phone

(215) 935-6493

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Annie Njolle Kotto, MD

  • Pediatrics Physician
  • Wyncote, PA
  • NPI 1871826297
  NPD Authorized official

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

{
    "created_epoch": "1569888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569888000000",
    "number": "1033750047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8080 OLD YORK RD STE 207",
            "city": "ELKINS PARK",
            "state": "PA",
            "postal_code": "190271426",
            "telephone_number": "215-935-6493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8080 OLD YORK RD STE 207",
            "city": "ELKINS PARK",
            "state": "PA",
            "postal_code": "190271426",
            "telephone_number": "215-935-6493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESTAGES PEDIATRICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-01",
        "last_updated": "2019-10-01",
        "status": "A",
        "authorized_official_last_name": "KOTTO",
        "authorized_official_first_name": "ANNIE",
        "authorized_official_title_or_position": "DIRECTOR/PHYSICIAN",
        "authorized_official_telephone_number": "215-935-6493",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1025509500009",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.officepracticum.com",
            "affiliation": "N",
            "endpointDescription": "Electronic Medical record",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "patient medical record",
            "address_1": "8080 Old York Rd Ste 207",
            "city": "Elkins Park",
            "state": "PA",
            "country_code": "US",
            "postal_code": "190271426",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cailin Ellen Lewis, CRNP-PC
• James S Lewis, M.D.
• Pingjia Li, CRNP
• Liberty Human Services, LLC
• Miriam Lichter
• Jill Susanne Lipschutz, MSS, LCSW
• Mengge Liu, DC
• Jamie Lo, MMS, PA-C
• Vincent Michael Long, PT, DPT, NCS, ATP
• Louise Catherine Lonsdale, PSY.D

• Pediatrics Physician in Elkins Park, PA
• Providers in Elkins Park, PA by specialty
• Pediatrics Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2019; 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.