Pediatric Associates of Kentwood

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

PEDIATRIC ASSOCIATES OF KENTWOOD

Practice address

4444 Kalamazoo Ave SE
Suite 103
Kentwood, MI 49508-4600

Phone

(616) 281-5800

Fax

(616) 281-5495

NPI assigned

May 10, 2006

Organization subpart

No

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

Authorized official

Name

Dr. James R Jokerst, MDNPI 1487762407

Title

President

Phone

26162815800

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

Locations

Practitioners 3

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

• James R Jokerst, M.D.

  • Pediatrics Physician
  • Kentwood, MI
  • NPI 1487762407

  Specialist

  NPD (past) Authorized official
• Dana L Leary, M.D.

  • Pediatrics Physician
  • Kentwood, MI
  • NPI 1134237167

  Specialist

  NPD (past)
• Dawn N Rosser, MD

  • Pediatrics Physician
  • Lansing, MI
  • NPI 1609830033
  NPD (past)

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174573471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4444 KALAMAZOO AVE SE",
            "address_2": "SUITE 103",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495084600",
            "telephone_number": "616-281-5800",
            "fax_number": "616-281-5495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4444 KALAMAZOO AVE SE",
            "address_2": "SUITE 103",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495084600",
            "telephone_number": "616-281-5800",
            "fax_number": "616-281-5495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ASSOCIATES OF KENTWOOD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOKERST",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "26162815800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nikkia Monique Parks, PHARMD
• Katherine G Pastoor, MA, LLP
• Pragyan Patro, MD
• Richard Maynard Peacock, RPH
• Pearle Vision Inc (Pearle Vision #C6658)
• Pediatric Partners PLC
• Nora Christine Peirano, PA
• Josh Pelton, BCBA
• Nichole Lynn Penny, R.PH.
• Perry Drug Stores Inc and Subsidiaries (Rite Aid Pharmacy 04395)

• Specialist in Kentwood, MI
• Providers in Kentwood, MI by specialty
• Specialist in Michigan

• 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.
• 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.