Pocket Pediatric Medical Group, Inc

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

225933 Issued in CA

Legal business name

POCKET PEDIATRIC MEDICAL GROUP, INC

Practice address

1355 Florin Rd Ste 10
Sacramento, CA 95822-4200

Phone

(916) 422-7273

Fax

(916) 422-2127

NPI assigned

Jan 13, 2014

Organization subpart

No

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

Authorized official

Name

Mey Thi Dominguez

Title

Manager

Phone

(916) 422-7273

Specialties & licenses 1

Addresses

Tax ID family

Land Park Pediatric Medical Group3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Land Park Pediatric Medical Group

  • Pediatrics Physician
  • Sacramento, CA
  • NPI 1487018990
  NPD tax ID
• Pocket Pediatrics, Inc.

  • Pediatric Adolescent Medicine Physician
  • Sacramento, CA
  • NPI 1386755262
  NPD tax ID

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

{
    "created_epoch": "1389571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389571200000",
    "number": "1235551037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 FLORIN RD STE 10",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958224200",
            "telephone_number": "916-422-7273",
            "fax_number": "916-422-2127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 FLORIN RD STE 10",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958224200",
            "telephone_number": "916-422-7273",
            "fax_number": "916-422-2127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POCKET PEDIATRIC MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-13",
        "last_updated": "2014-01-13",
        "status": "A",
        "authorized_official_last_name": "DOMINGUEZ",
        "authorized_official_first_name": "MEY",
        "authorized_official_middle_name": "THI",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "916-422-7273"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "225933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah PO, DMD
• Janet Susan Poarch-Nugent, RN
• Nicolette M Poblete
• Edward Joseph Pochay, CMPSS
• Alyssa Simon Pociernicki
• Pocket Pediatrics, Inc.
• Aleksander Leonidovich Podlubny, MS
• Alec Poe
• Andy Poe
• Carson Poe

• Pediatric Nurse Practitioner in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Pediatric Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2014; 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.