Little Legends Pediatrics LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

LITTLE LEGENDS PEDIATRICS LLC

Practice address

169 W High St
Mount Gilead, OH 43338-1214

Phone

(419) 751-7050

Fax

(740) 513-4628

NPI assigned

Jan 9, 2024

Organization subpart

No

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

Authorized official

Name

Martie J Gravitt, MDNPI 1083827299

Title

Owner

Phone

(417) 699-8682

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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

• Martie John Gravitt, M.D.

  • Pediatrics Physician
  • Mount Gilead, OH
  • NPI 1083827299
  NPD Authorized official

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

{
    "created_epoch": "1704758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704758400000",
    "number": "1265203384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 W HIGH ST",
            "city": "MOUNT GILEAD",
            "state": "OH",
            "postal_code": "433381214",
            "telephone_number": "419-751-7050",
            "fax_number": "740-513-4628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 W HIGH ST",
            "city": "MOUNT GILEAD",
            "state": "OH",
            "postal_code": "433381214",
            "telephone_number": "419-751-7050",
            "fax_number": "740-513-4628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLE LEGENDS PEDIATRICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-09",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A",
        "authorized_official_last_name": "GRAVITT",
        "authorized_official_first_name": "MARTIE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "417-699-8682",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tomoko Kobayashi Sherrod, LPCC-S
• Christopher L Kopcak, PT
• Lane Drug Co (Rite Aid Pharmacy 02419)
• Allisun Lauthers
• Lisa B Levering, PT
• LM Consulting Dietians LLC
• Christine M Lyons, LPN
• Justin Lee Mast, PHARM.D.
• Mohammed Masum
• Matt Hintz MD, LLC

• Pediatrics Physician in Mount Gilead, OH
• Providers in Mount Gilead, OH by specialty
• Pediatrics Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.