Javelina Pediatrics PLLC

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

33911 Issued in AZ

Legal business name

JAVELINA PEDIATRICS PLLC

Practice address

1521 E Tangerine Rd
Suite 205
Oro Valley, AZ 85755-6225

Phone

(520) 531-0060

Fax

(520) 225-0156

NPI assigned

Jul 7, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Philip S Traquair, MD

Title

President

Phone

(520) 531-0060

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232496000000",
    "number": "1265464424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1521 E TANGERINE RD",
            "address_2": "SUITE 205",
            "city": "ORO VALLEY",
            "state": "AZ",
            "postal_code": "857556225",
            "telephone_number": "520-531-0060",
            "fax_number": "520-225-0156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 E TANGERINE RD",
            "address_2": "SUITE 205",
            "city": "ORO VALLEY",
            "state": "AZ",
            "postal_code": "857556225",
            "telephone_number": "520-531-0060",
            "fax_number": "520-225-0156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAVELINA PEDIATRICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2009-01-21",
        "status": "A",
        "authorized_official_last_name": "TRAQUAIR",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "520-531-0060",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "AZ",
            "license": "33911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "945925",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Jacobson, MD
• James F Pager DMD, PLLC
• James M. Flynn, D.D.S., P.C.
• Carly Jaquez, DDS
• Jennifer Tatiana Jara Gomez, MD
• Justine Jenkins, RN
• Jamie Kerin Jeremie, FNP-C
• Jess Haymore, DDS,PC
• Tammy Jncharles
• Johnson & Chang Dentistry, PLLC

• Pediatric Adolescent Medicine Physician in Oro Valley, AZ
• Providers in Oro Valley, AZ by specialty
• Pediatric Adolescent Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2009; 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.