Organization Active NPI

Amarillo Pediatric Clinic, PLLC

  • Nurse Practitioner
  • Amarillo, TX
National Provider Identifier
1164892956
Registry record updated Oct 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
AMARILLO PEDIATRIC CLINIC, PLLC
Practice address
1901 Medi Park Dr
Ste 65
Amarillo, TX 79106-2110
Phone
(806) 468-4317
NPI assigned
Oct 6, 2015
Last updated
Oct 6, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2015

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

Authorized official

Name
Erica Leathers, NPNPI 1043394752
Title
Managing Partner
Phone
(806) 359-1046

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU Primary

Addresses

Primary practice location

1901 Medi Park Dr
Ste 65
Amarillo, TX 79106-2110

Mailing address

1901 Medi Park Dr
Ste 65
Amarillo, TX 79106-2110

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2104921Amarillo Pediatric Clinic, PLLC1901 Medi-Park Drive, Suite 65, Amarillo, TX 79106Certificate of waiverNov 15, 2027

National Provider Directory

National Provider Directory

Locations

1901 Medi Park Dr
Ste 65
Amarillo, TX 79106
Phone (806) 468-7611

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1444089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444089600000",
    "number": "1164892956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 MEDI PARK DR",
            "address_2": "STE 65",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791062110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 MEDI PARK DR",
            "address_2": "STE 65",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791062110",
            "telephone_number": "806-468-4317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMARILLO PEDIATRIC CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-06",
        "last_updated": "2015-10-06",
        "status": "A",
        "authorized_official_last_name": "LEATHERS",
        "authorized_official_first_name": "ERICA",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "806-359-1046",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.