NPIMap

Organization Active NPI

Putnam County Pediatrics

  • Pediatrics Physician
  • Cookeville, TN
National Provider Identifier
1215054754
Registry record updated Mar 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PUTNAM COUNTY PEDIATRICS
Practice address
758 S Willow Ave
Cookeville, TN 38501-3840
Phone
(931) 526-6173
Fax
(931) 526-5084
NPI assigned
Mar 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2014

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

Authorized official

Name
Dr. Christopher D Climaco, MDNPI 1972508703
Title
Physician Owner
Phone
(931) 526-6173

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary
Pediatric Cardiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0202X

Addresses

Primary practice location

758 S Willow Ave
Cookeville, TN 38501-3840

Mailing address

758 S Willow Ave
Cookeville, TN 38501-3840
Phone (931) 526-6173

Other names 1

  • Kids Kare Pediatrics Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200909001949 TN Part B Supplier - Clinic/Group Practice 1850719766 Receives reassigned benefits from 1 practitioner
Practice locations: Cookeville, TN

National Provider Directory

National Provider Directory

Locations

758 S Willow Ave
Cookeville, TN 38501
Phone (931) 526-6173

328 Antioch Pike
Nashville, TN 37211
Phone (615) 832-8641

Practitioners & affiliated clinicians

Practitioners 10

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

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393977600000",
    "number": "1215054754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "758 S WILLOW AVE",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385013840",
            "telephone_number": "931-526-6173",
            "fax_number": "931-526-5084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "758 S WILLOW AVE",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385013840",
            "telephone_number": "931-526-6173",
            "fax_number": "931-526-5084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUTNAM COUNTY PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2014-03-05",
        "status": "A",
        "authorized_official_last_name": "CLIMACO",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PHYSICIAN   OWNER",
        "authorized_official_telephone_number": "931-526-6173",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kids Kare Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cookeville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.