Pediatric Gastroenterology & Nutrition of Western Ma

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

PEDIATRIC GASTROENTEROLOGY & NUTRITION OF WESTERN MA

Practice address

2 Medical Center Dr
Springfield, MA 01107-1270

Phone

(413) 733-4450

NPI assigned

Dec 27, 2005

Last updated

Aug 22, 2020By 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

None None, MD

Title

President

Phone

(800) 927-0002

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1135641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093792533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9132",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024469132",
            "telephone_number": "800-927-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MEDICAL CENTER DR",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071270",
            "telephone_number": "413-733-4450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC GASTROENTEROLOGY & NUTRITION OF WESTERN MA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NONE",
        "authorized_official_first_name": "NONE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "800-927-0002",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9710931",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hanna Peck, NP
• Mariah Peck
• Pamela J Peck, NP
• Elizabeth Pecoy-Whitcomb, P.A.
• Pediatric Care Associates, P.C.
• Pediatric Gastroenterology and Nutrition Group, P.C.
• Pediatric Orthotic and Prosthetic Services-Northeast,LLC
• Pediatric Pulmonology of Western New England, P.C.
• Pediatric Surgical Services, Inc
• Kimberly A Pedigo, PA-C

• Pediatrics Physician in Springfield, MA
• Providers in Springfield, MA by specialty
• Pediatrics Physician in Massachusetts

• 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.