Pediatric Associates of Paoli, PC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

PEDIATRIC ASSOCIATES OF PAOLI, PC

Doing business as

Pediatric Associates of Paoli

Practice address

17 Industrial Blvd
Suite 204
Paoli, PA 19301-1607

Phone

(610) 647-1484

Fax

(610) 647-7068

NPI assigned

Mar 15, 2006

Last updated

Nov 20, 2007By 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

Terry Kienzle

Title

Office Manager

Phone

(610) 647-1484

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pediatric Associates of Paoli Doing business as

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/17038/brand/1/csg/1/fhir/r4

Practitioners 3

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.

• Andrew J Forman, DO

  • Pediatrics Physician
  • Paoli, PA
  • NPI 1871561647
  NPD (past)
• G. Edward Kienzle, MD

  • Pediatrics Physician
  • Paoli, PA
  • NPI 1174590244
  NPD (past)
• Rand E Kienzle, MD

  • Pediatrics Physician
  • Paoli, PA
  • NPI 1003884891
  NPD (past)

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195516800000",
    "number": "1083683742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 INDUSTRIAL BLVD",
            "address_2": "SUITE 204",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011607",
            "telephone_number": "610-647-1484",
            "fax_number": "610-647-7068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 INDUSTRIAL BLVD",
            "address_2": "SUITE 204",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011607",
            "telephone_number": "610-647-1484",
            "fax_number": "610-647-7068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ASSOCIATES OF PAOLI, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-15",
        "last_updated": "2007-11-20",
        "status": "A",
        "authorized_official_last_name": "KIENZLE",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "610-647-1484"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "897325",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Associates of Paoli",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nirav S. Patel, D.C.
• William Leonard Patton
• Mitchell H Paulin, MD
• Kimberly Ann Payne, NPC
• Mark William Pearson, DC
• Pediatric Eye Physicians & Surgeons PC
• Sandra Ellen Pellatt, DNP, CRNP
• Ann Marie Pellegrino, CRNP APRNC
• Marissa Pena
• Christina M Penderghest, CRNP

• Pediatrics Physician in Paoli, PA
• Providers in Paoli, PA by specialty
• Pediatrics Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2007; 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.