Pediatric Clinic of West Monroe

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

PEDIATRIC CLINIC OF WEST MONROE

Practice address

104 Contempo Ave
West Monroe, LA 71291-5312

Phone

(318) 329-8181

Fax

(318) 329-8183

NPI assigned

Dec 13, 2005

Organization subpart

No

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

Authorized official

Name

Kim Malmay, M.D.

Title

President

Phone

(318) 329-8181

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265417141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 CONTEMPO AVE",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712915312",
            "telephone_number": "318-329-8181",
            "fax_number": "318-329-8183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 CONTEMPO AVE",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712915312",
            "telephone_number": "318-329-8181",
            "fax_number": "318-329-8183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC CLINIC OF WEST MONROE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MALMAY",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "318-329-8181",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1450979",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Freddy Patterson, M,ED
• Cherry M. Patton, NP
• Peaceful Hearts Counseling, LLC
• Peach Tree Dental West Monroe, LLC
• Nathan Edward Pearson, FNP
• Pegasus Primary Providers, LLC
• Dawn W Pennebaker, M.D.
• Kenyatta Percy
• Jennifer Perodeau, LOTR
• Holley Marie Perry, CCC/SLP

• Pediatrics Physician in West Monroe, LA
• Providers in West Monroe, LA by specialty
• Pediatrics Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.