NPIMap

Organization Active NPI

Freeport Pediatrics, S.C

  • Pediatrics Physician
  • Freeport, IL
National Provider Identifier
1194910729
Registry record updated Sep 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
FREEPORT PEDIATRICS, S.C
Practice address
750 Kiwanis Dr
Freeport, IL 61032-7119
Phone
(815) 235-9233
Fax
(815) 235-9254
NPI assigned
Sep 6, 2007
Last updated
Sep 6, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2007

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

Authorized official

Name
Dr. Prasad Thomas, M.DNPI 1144296351
Title
Pediatrician
Phone
(815) 235-9233

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X IL Primary

Addresses

Primary practice location

750 Kiwanis Dr
Freeport, IL 61032-7119

Mailing address

750 Kiwanis Dr
Freeport, IL 61032-7119
Phone (815) 235-9233

National Provider Directory

National Provider Directory

Locations

750 Kiwanis Dr
Freeport, IL 61032
Phone (815) 235-9233

Practitioners & affiliated clinicians

Practitioners 1

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": "1189036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189036800000",
    "number": "1194910729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 KIWANIS DR",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610327119",
            "telephone_number": "815-235-9233",
            "fax_number": "815-235-9254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 KIWANIS DR",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610327119",
            "telephone_number": "815-235-9233",
            "fax_number": "815-235-9254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEPORT PEDIATRICS, S.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-06",
        "last_updated": "2007-09-06",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "PRASAD",
        "authorized_official_title_or_position": "PEDIATRICIAN",
        "authorized_official_telephone_number": "815-235-9233",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeport, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2007; 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.