Organization Active NPI

Robert W. Childs, MD, and Associates

  • Pediatrics Physician
  • Hazleton, PA
National Provider Identifier
1104094713
Registry record updated Feb 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD014506E Issued in PA
Legal business name
ROBERT W. CHILDS, MD, AND ASSOCIATES
Practice address
1730 E Broad St
Suite 2
Hazleton, PA 18201-5622
Phone
(570) 455-9589
Fax
(570) 455-8848
NPI assigned
Feb 16, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2008

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

Authorized official

Name
Dr. Robert William Childs, M.D.
Title
Owner
Phone
(570) 455-9589

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X MD014506E PA Primary

Addresses

Primary practice location

1730 E Broad St
Suite 2
Hazleton, PA 18201-5622

Mailing address

1730 E Broad St
Suite 2
Hazleton, PA 18201-5622
Phone (570) 455-9589

Other identifiers 1

IdentifierTypeStateIssuer
0005875560001MedicaidPA

National Provider Directory

National Provider Directory

Locations

1730 E Broad St
Ste 2
Hazleton, PA 18201
Phone (570) 455-7823

NPI Registry JSON

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

{
    "created_epoch": "1203120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203120000000",
    "number": "1104094713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 E BROAD ST",
            "address_2": "SUITE 2",
            "city": "HAZLETON",
            "state": "PA",
            "postal_code": "182015622",
            "telephone_number": "570-455-9589",
            "fax_number": "570-455-8848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 E BROAD ST",
            "address_2": "SUITE 2",
            "city": "HAZLETON",
            "state": "PA",
            "postal_code": "182015622",
            "telephone_number": "570-455-9589",
            "fax_number": "570-455-8848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT W. CHILDS, MD, AND ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-16",
        "last_updated": "2008-02-16",
        "status": "A",
        "authorized_official_last_name": "CHILDS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "570-455-9589",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD014506E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005875560001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazleton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2008; 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.