NPIMap

Organization Active NPI

Pediatrics Primary Care PLLC

  • Primary Care Clinic/Center
  • Wyoming, MI
National Provider Identifier
1194997825
Registry record updated Apr 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
4301066298 Issued in MI
Legal business name
PEDIATRICS PRIMARY CARE PLLC
Practice address
4433 Byron Center Ave SW
Pediatrics Primary Care
Wyoming, MI 49519
Phone
(616) 530-2846
Fax
(616) 530-2854
NPI assigned
Apr 2, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2008

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

Authorized official

Name
Buenaventura Carmen Pereyra, MD
Title
Pediatrician
Phone
(616) 530-2846

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 4301066298 MI Primary

Addresses

Primary practice location

4433 Byron Center Ave SW
Pediatrics Primary Care
Wyoming, MI 49519

Mailing address

4433 Byron Center Ave SW
Pediatrics Primary Care
Wyoming, MI 49519

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207094400000",
    "number": "1194997825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4433 BYRON CENTER AVE SW",
            "address_2": "PEDIATRICS PRIMARY CARE",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "49519",
            "fax_number": "616-530-2854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4433 BYRON CENTER AVE SW",
            "address_2": "PEDIATRICS PRIMARY CARE",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "49519",
            "telephone_number": "616-530-2846",
            "fax_number": "616-530-2854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRICS PRIMARY CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-02",
        "last_updated": "2008-04-02",
        "status": "A",
        "authorized_official_last_name": "PEREYRA",
        "authorized_official_first_name": "BUENAVENTURA",
        "authorized_official_middle_name": "CARMEN",
        "authorized_official_title_or_position": "PEDIATRICIAN",
        "authorized_official_telephone_number": "616-530-2846",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MI",
            "license": "4301066298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2008; 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.