Danville Pediatrics and Primary Care, PLLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

DANVILLE PEDIATRICS AND PRIMARY CARE, PLLC

Practice address

303 S 4TH St
Danville, KY 40422-2004

Phone

(859) 236-1080

Fax

(859) 236-1862

NPI assigned

Aug 21, 2006

Last updated

Oct 7, 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

Jeremy Dickinson, M.D.NPI 1831150085

Title

Medical Director

Phone

(859) 236-1080

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 3

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.

• Jeremy T Dickinson, M.D.

  • Pediatrics Physician
  • Danville, KY
  • NPI 1831150085
  Authorized official Same address or phone
• Caroline Pellegrino

  • Pediatric Nurse Practitioner
  • Danville, KY
  • NPI 1679170104
  NPD (past)
• Jonathan E Ricker, M.D.

  • Pediatrics Physician
  • Lexington, KY
  • NPI 1992766133
  NPD (past)

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633564800000",
    "number": "1265547723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 S 4TH ST",
            "city": "DANVILLE",
            "state": "KY",
            "postal_code": "404222004",
            "telephone_number": "859-236-1080",
            "fax_number": "859-236-1862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 S 4TH ST",
            "city": "DANVILLE",
            "state": "KY",
            "postal_code": "404222004",
            "telephone_number": "859-236-1080",
            "fax_number": "859-236-1862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANVILLE PEDIATRICS AND PRIMARY CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A",
        "authorized_official_last_name": "DICKINSON",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "859-236-1080",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100000530",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danville Nephrology Consultants
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• Danville Pathology Associates PLLP
• Danville Pediatric Dentistry, PSC
• Danville Pediatrics and Primary Care, PLLC
• Danville Pediatrics Medical Group PLLC
• Danville Pediatrics, PSC
• Danville Peds Dre LLC
• Danville Physical Therapy PLLC

• Pediatrics Physician in Danville, KY
• Providers in Danville, KY by specialty
• Pediatrics Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 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.