NPIMap

Organization Active NPI

Caro Pediatric Center

  • Pediatrics Physician
  • Dayton, OH
National Provider Identifier
1093084584
Registry record updated Dec 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
34-002567 Issued in OH
Legal business name
CARO PEDIATRIC CENTER
Practice address
1435 Shoup Mill Rd
Dayton, OH 45414-3978
Phone
(937) 275-3488
Fax
(937) 275-3371
NPI assigned
Dec 29, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2011

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

Authorized official

Name
Ms. Stacy L Green
Title
Office Manager
Phone
(937) 275-8559

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208000000X 35-056515-C OH
Pediatrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208000000X 34-002567 OH Primary

Addresses

Primary practice location

1435 Shoup Mill Rd
Dayton, OH 45414-3978

Mailing address

1435 Shoup Mill Rd
Dayton, OH 45414-3978
Phone (937) 275-3488

Other identifiers 2

IdentifierTypeStateIssuer
0535326MedicaidOH
0696180MedicaidOH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D1029548Caro Pediatric Center1435 Shoup Mill Road, Dayton, OH 45414Certificate of waiverAug 17, 2026

National Provider Directory

National Provider Directory

Locations

1435 Shoup Mill Rd
Dayton, OH 45414
Phone (937) 275-3488

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1866

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1325116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325116800000",
    "number": "1093084584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1435 SHOUP MILL RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454143978",
            "telephone_number": "937-275-3488",
            "fax_number": "937-275-3371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1435 SHOUP MILL RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454143978",
            "telephone_number": "937-275-3488",
            "fax_number": "937-275-3371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARO PEDIATRIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-29",
        "last_updated": "2011-12-29",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "937-275-8559",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35-056515-C",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "34-002567",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0535326",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0696180",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.