Pediatric Radiology, P.a.

Primary specialty

Pediatric Radiology PhysicianTaxonomy code 2085P0229X

Legal business name

PEDIATRIC RADIOLOGY, P.A.

Practice address

2525 Chicago Ave
Minneapolis, MN 55404-4518

Phone

(612) 813-8200

NPI assigned

May 20, 2006

Organization subpart

No

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

Authorized official

Name

Leland Prewitt Jr., MD

Title

President

Phone

(612) 813-8200

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124072673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 46100",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554460100",
            "telephone_number": "763-553-9920",
            "fax_number": "763-553-9910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044518",
            "telephone_number": "612-813-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC RADIOLOGY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PREWITT",
        "authorized_official_first_name": "LELAND",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "612-813-8200",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085P0229X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Pediatric Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristina L Pederson
• Paris Pederson, LADC
• Suzanne K Pederson, M.S., L.P.
• Valerie Pederson, MS, LPCC
• Pediatric ENT Associates
• Pediatric Surgical Associates LTD
• Pediatric Urology Associates, P.a.
• Peek Pca
• Syed Murfad Peer, M.D
• Abbas H Peera, M.D.

• Pediatric Radiology Physician in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Pediatric Radiology Physician in Minnesota

• 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.