NPIMap

Organization Active NPI

Little Pine Pediatrics, PLLC

  • Primary Care Clinic/Center
  • Madison, FL
National Provider Identifier
1043761539
Registry record updated Jan 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
LITTLE PINE PEDIATRICS, PLLC
Practice address
194 NE Hancock Ave
Madison, FL 32340-2546
Phone
(850) 253-2275
Fax
(850) 253-2280
NPI assigned
Oct 19, 2016
Last updated
Jan 13, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2017

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

Authorized official

Name
Ronald Emerick, D.O
Title
Owner/Medical Director
Phone
(850) 253-2275

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU Primary

Addresses

Primary practice location

194 NE Hancock Ave
Madison, FL 32340-2546

Mailing address

194 NE Hancock Ave
Madison, FL 32340-2546
Phone (850) 253-2275

Other identifiers 1

IdentifierTypeStateIssuer
001165802MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Little Pine Pediatrics PLLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1476835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484265600000",
    "number": "1043761539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "194 NE HANCOCK AVE",
            "city": "MADISON",
            "state": "FL",
            "postal_code": "323402546",
            "telephone_number": "850-253-2275",
            "fax_number": "850-253-2280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "194 NE HANCOCK AVE",
            "city": "MADISON",
            "state": "FL",
            "postal_code": "323402546",
            "telephone_number": "850-253-2275",
            "fax_number": "850-253-2280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLE PINE PEDIATRICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-19",
        "last_updated": "2017-01-13",
        "status": "A",
        "authorized_official_last_name": "EMERICK",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "OWNER/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "850-253-2275",
        "authorized_official_credential": "D.O"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001165802",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2017; 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.