Pediatric Gastroenterology Inc

Primary specialty

Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X

License

ME101913 Issued in FL

Legal business name

PEDIATRIC GASTROENTEROLOGY INC

Doing business as

Pediatric Gastroenterology of Alaska

Practice address

4500 Business Park Blvd
Suite C-10
Anchorage, AK 99503

Phone

(907) 770-2880

Fax

(907) 770-2882

NPI assigned

Mar 10, 2017

Last updated

Jan 25, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ajay D Gohil, MDNPI 1780757906

Title

Owner/Provider

Phone

(907) 770-2880

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pediatric Gastroenterology of Alaska Doing business as

Locations

Practitioners 1

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.

• Ajay Gohil, MD

  • Pediatric Gastroenterology Physician
  • Albuquerque, NM
  • NPI 1780757906
  NPD Authorized official

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

{
    "created_epoch": "1489104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611532800000",
    "number": "1245771252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 241769",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995241769",
            "telephone_number": "907-770-2380",
            "fax_number": "907-770-2390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 BUSINESS PARK BLVD",
            "address_2": "SUITE C-10",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "99503",
            "telephone_number": "907-770-2880",
            "fax_number": "907-770-2882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC GASTROENTEROLOGY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-10",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A",
        "authorized_official_last_name": "GOHIL",
        "authorized_official_first_name": "AJAY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "907-770-2880",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "FL",
            "license": "ME101913",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015979100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Gastroenterology of Alaska",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Casey Peavy
• Emme Lynn Adryanne Peavy
• Carly Peckham
• Inaam A Pedalino, DDS
• Veronica Rae Peddada, FNP-BC
• Pediatric Gastroenterology of Alaska, LLC
• Pediatric Neurology Clinic of Alaska, P.C.
• Pediatric Neuropsychological Services of Alaska, PC
• Pediatric OT Services, LLC
• Pediatric Specialists of Alaska LLC (Barbara J. Coopes, MD)

• Pediatric Gastroenterology Physician in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Pediatric Gastroenterology Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; 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.