Psa Pediatric Nephrology

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

PSA PEDIATRIC NEPHROLOGY

Practice address

1665 Medical Blvd
Naples, FL 34110-1402

Phone

(305) 662-8352

Fax

(305) 669-6545

NPI assigned

Mar 3, 2016

Organization subpart

Yes

Parent organization

PEDIATRIC SPECIALTY GROUP, INC.As reported in NPPES

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

Authorized official

Name

Mr. Timothy Birkenstock

Title

SVP & Cfo for MCHS

Phone

(305) 669-6422

Specialties & licenses 1

Addresses

Tax ID family

Psa Pediatric Nephrology2 organizations share this tax ID, including this one

Part of

Pediatric Specialty Group Inc

Other organizations with this tax ID 1

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

• Psa Pediatric Nephrology

  • Pediatric Nephrology Physician
  • Miami, FL
  • NPI 1477901916
  NPD tax ID

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Pediatric Specialty Group, Inc

  • Pediatric Orthopaedic Surgery Physician
  • Coconut Creek, FL
  • NPI 1003306093
  NPPES parent name

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

{
    "created_epoch": "1456963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456963200000",
    "number": "1124488127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 SW 62ND AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331553009",
            "telephone_number": "305-662-8352",
            "fax_number": "305-669-6545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1665 MEDICAL BLVD",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341101402",
            "telephone_number": "305-662-8352",
            "fax_number": "305-669-6545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSA PEDIATRIC NEPHROLOGY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PEDIATRIC SPECIALTY GROUP, INC.",
        "enumeration_date": "2016-03-03",
        "last_updated": "2016-03-03",
        "status": "A",
        "authorized_official_last_name": "BIRKENSTOCK",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "SVP & CFO FOR MCHS",
        "authorized_official_telephone_number": "305-669-6422",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sally Joan Prost, L.P.C.
• William J Provance, DO
• Kayla Prues, PHARM D
• Kelly Nicole Pryce, LCSW
• Mark Franklin Prysi, M.D.
• Pse of Naples PLLC
• Psychiatric Associates of Florida PLLC
• Psychotherapy SW FL
• Psynergy Services LLC
• Publix Super Markets Inc

• Nephrology Physician in Naples, FL
• Providers in Naples, FL by specialty
• Nephrology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2016; 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.