NPIMap

Organization Active NPI

Children's Community Care

Doing business as Children's Community Pediatrics

  • Pediatrics Physician
  • Blairsville, PA
National Provider Identifier
1255349668
Registry record updated Sep 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
CHILDREN'S COMMUNITY CARE
Doing business as
Children's Community Pediatrics
Practice address
56 Club LN
Blairsville, PA 15717-7957
Phone
(724) 459-6560
NPI assigned
Aug 3, 2006
Last updated
Sep 13, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2023

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

Authorized official

Name
Lori Martinez
Title
Executive Administrator III
Phone
(724) 933-1100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

56 Club LN
Blairsville, PA 15717-7957

Mailing address

103 Bradford Rd Ste 200
Wexford, PA 15090-6910
Phone (724) 933-1100

Other identifiers 1

IdentifierTypeStateIssuer
001597376OtherPAHIGHMARK ID#

Other names 1

  • Children's Community Pediatrics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Children's Community Pediatrics62 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

103 Bradford Rd
Ste 200
Wexford, PA 15090

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694563200000",
    "number": "1255349668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 BRADFORD RD STE 200",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150906910",
            "telephone_number": "724-933-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 CLUB LN",
            "city": "BLAIRSVILLE",
            "state": "PA",
            "postal_code": "157177957",
            "telephone_number": "724-459-6560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S COMMUNITY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "EXECUTIVE ADMINISTRATOR III",
        "authorized_official_telephone_number": "724-933-1100"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK ID#",
            "identifier": "001597376",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Children's Community Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Children's Community Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Blairsville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; 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.