Providence Pediatrics, PC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD046306-L Issued in PA

Legal business name

PROVIDENCE PEDIATRICS, PC

Practice address

338 Russell Avenue
Williamsport, PA 17701

Phone

(570) 326-5720

Fax

(570) 601-1522

NPI assigned

Feb 14, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Joseph Demay, MDNPI 1457459166

Title

President

Phone

(570) 326-5720

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Providence Pediatrics Other name

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.

• Joseph Demay, M.D.

  • Pediatric Adolescent Medicine Physician
  • Williamsport, PA
  • NPI 1457459166
  NPD (past) Authorized official

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294704000000",
    "number": "1265575955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "338 RUSSELL AVENUE",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "17701",
            "telephone_number": "570-326-5720",
            "fax_number": "570-601-1522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "338 RUSSELL AVENUE",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "17701",
            "telephone_number": "570-326-5720",
            "fax_number": "570-601-1522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE PEDIATRICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2011-01-11",
        "status": "A",
        "authorized_official_last_name": "DEMAY",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "570-326-5720",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD046306-L",
            "primary": true
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "PA",
            "license": "MD046306L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012712310004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Providence Pediatrics",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Price Optometric Group LLC
• Malachi Thomas Price, PA-C
• Fnu Prinkiya, MD
• Sandra K. Probst, M.A.
• Joy Elaine Proctor, PT, DPT
• Kellie Forziat Pytel, PHD, LPC, NCC
• Nicholas Pytel
• Allyson Quigley, PA-C
• David Quintana, MD
• Mark A Rackish, M.D.

• Pediatrics Physician in Williamsport, PA
• Providers in Williamsport, PA by specialty
• Pediatrics Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2011; 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.