Organization Active NPI

Pediatrix Medical Group PC

  • Neonatal-Perinatal Medicine Physician
  • Winchester, VA
National Provider Identifier
1205928587
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
Legal business name
PEDIATRIX MEDICAL GROUP PC
Practice address
1840 Amherst St FL 1
Winchester, VA 22601-2808
Phone
(540) 536-8000
Fax
(954) 851-1948
NPI assigned
Sep 28, 2006
Last updated
Jul 24, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Authorized official

Name
Nicholas E. Glaser
Title
Assistant Secretary
Phone
(954) 384-0175

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
Neonatal-Perinatal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080N0001X Primary
AudiologistGroup: 193200000X MULTI-SPECIALTY GROUP 231H00000X
Neonatal Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LN0000X

Addresses

Primary practice location

1840 Amherst St FL 1
Winchester, VA 22601-2808

Mailing address

PO Box 100445
Atlanta, GA 30384-0445
Phone (954) 384-0175

National Provider Directory

National Provider Directory
Tax ID family
Pediatrix Medical Group PC10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

1840 Amherst St
Fl 1
Winchester, VA 22601

Practitioners & affiliated clinicians

Practitioners 30

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.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753315200000",
    "number": "1205928587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100445",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303840445",
            "telephone_number": "954-384-0175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 AMHERST ST FL 1",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226012808",
            "telephone_number": "540-536-8000",
            "fax_number": "954-851-1948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIX MEDICAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A",
        "authorized_official_last_name": "GLASER",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "954-384-0175"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Neonatal",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2025; 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.