Associates in Pediatrics

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0101052086 Issued in VA

Legal business name

ASSOCIATES IN PEDIATRICS

Practice address

11551 Nuckols Rd
Suite F
Glen Allen, VA 23059-5565

Phone

(808) 364-4400

Fax

(804) 364-0120

NPI assigned

Mar 22, 2007

Organization subpart

No

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

Authorized official

Name

Keith Andrew Derco, M.D.

Title

President

Phone

(804) 364-4400

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221004800000",
    "number": "1225155781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11551 NUCKOLS RD",
            "address_2": "SUITE F",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230595565",
            "telephone_number": "808-364-4400",
            "fax_number": "804-364-0120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11551 NUCKOLS RD",
            "address_2": "SUITE F",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230595565",
            "telephone_number": "808-364-4400",
            "fax_number": "804-364-0120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATES IN PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2008-09-10",
        "status": "A",
        "authorized_official_last_name": "DERCO",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "804-364-4400",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101052086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Glen Allen, VA
• Providers in Glen Allen, VA by specialty
• Pediatrics Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.