NPIMap

Organization Active NPI

West Haven Pediatrics, LLC

  • Pediatrics Physician
  • West Haven, CT
National Provider Identifier
1104294644
Registry record updated Dec 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
WEST HAVEN PEDIATRICS, LLC
Practice address
367 Elm St
West Haven, CT 06516-4217
Phone
(203) 932-3227
Fax
(203) 931-2848
NPI assigned
Sep 14, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2015

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

Authorized official

Name
Dr. Jobey Jacob, MDNPI 1114167350
Title
Owner
Phone
(203) 932-3227

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X
Pediatric Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0200X

Addresses

Primary practice location

367 Elm St
West Haven, CT 06516-4217

Mailing address

367 Elm St
West Haven, CT 06516-4217
Phone (203) 932-3227

National Provider Directory

National Provider Directory
Tax ID family
West Haven Pediatrics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1442188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450915200000",
    "number": "1104294644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "367 ELM ST",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065164217",
            "telephone_number": "203-932-3227",
            "fax_number": "203-931-2848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "367 ELM ST",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065164217",
            "telephone_number": "203-932-3227",
            "fax_number": "203-931-2848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST HAVEN PEDIATRICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-14",
        "last_updated": "2015-12-24",
        "status": "A",
        "authorized_official_last_name": "JACOB",
        "authorized_official_first_name": "JOBEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-932-3227",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2015; 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.