NPIMap

Organization Active NPI

Marshall County Pediatrics, PC

  • Specialist
  • Guntersville, AL
National Provider Identifier
1043242514
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
6719 Issued in AL
Legal business name
MARSHALL COUNTY PEDIATRICS, PC
Practice address
45 Medical Park Dr Ste B
Guntersville, AL 35976-6999
Phone
(256) 571-8969
Fax
(256) 571-8980
NPI assigned
Jul 7, 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
John Mallory Packard Jr., MD
Title
President
Phone
(256) 571-8969

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 6719 AL Primary

Addresses

Primary practice location

45 Medical Park Dr Ste B
Guntersville, AL 35976-6999

Mailing address

45 Medical Park Dr Ste B
Guntersville, AL 35976-6999
Phone (256) 571-8969

National Provider Directory

National Provider Directory
Tax ID family
Marshall County Pediatrics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

2525 US Highway 431
Ste 210
Boaz, AL 35957
Phone (256) 840-4601

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043242514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 MEDICAL PARK DR STE B",
            "city": "GUNTERSVILLE",
            "state": "AL",
            "postal_code": "359766999",
            "telephone_number": "256-571-8969",
            "fax_number": "256-571-8980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 MEDICAL PARK DR STE B",
            "city": "GUNTERSVILLE",
            "state": "AL",
            "postal_code": "359766999",
            "telephone_number": "256-571-8969",
            "fax_number": "256-571-8980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARSHALL COUNTY PEDIATRICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PACKARD",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "MALLORY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "256-571-8969",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "AL",
            "license": "6719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guntersville, AL

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.