NPIMap

Children'S Community Care

Organization Active NPI Pediatrics Physician · Greensburg, PA

NPI 1124036637 · NPPES record last updated Sep 13, 2023

Key facts

NPI
1124036637
Entity type
Organization (NPI type 2)
Primary specialty
Pediatrics Physician 208000000X
Legal business name
CHILDREN'S COMMUNITY CARE
Practice address
200 Village Dr Ste B
Greensburg, PA 15601-3783
Phone
(724) 832-0850
Fax
(724) 832-1623
NPI assigned
Aug 3, 2006
Organization subpart
No

Authorized official

Name
Lori Martinez
Title
Executive Administrator III
Phone
(724) 933-1100

Corporate family (same tax ID) 18

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

Practitioners 21

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

National Provider Directory

Tax ID family
Children'S Community Pediatrics (62 organizations share this tax ID)

Locations

56 Club Ln
Blairsville, PA 15717
Phone (724) 459-5203

103 Bradford Rd
Ste 200
Wexford, PA 15090

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 208000000X Yes

Addresses

Primary practice location

200 Village Dr Ste B
Greensburg, PA 15601-3783

Mailing address

103 Bradford Rd Ste 200
Wexford, PA 15090-6910
Phone (724) 933-1100

Other identifiers

IdentifierTypeStateIssuer
001597371OtherPAHIGHMARK ID#

Other names

  • Children's Community Pediatrics Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 13, 2023.

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694563200000",
    "number": "1124036637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 BRADFORD RD STE 200",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150906910",
            "telephone_number": "724-933-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 VILLAGE DR STE B",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156013783",
            "telephone_number": "724-832-0850",
            "fax_number": "724-832-1623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S COMMUNITY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "EXECUTIVE ADMINISTRATOR III",
        "authorized_official_telephone_number": "724-933-1100"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK ID#",
            "identifier": "001597371",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Children's Community Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Children's Community Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greensburg, PA

All providers in Greensburg, PA · Pediatrics Physician in Pennsylvania

Sources for this page

Verify at the official NPI Registry.