NPIMap

Organization Active NPI

Grove Park Pediatrics

  • Pediatrics Physician
  • Burlington, NC
National Provider Identifier
1275788416
Registry record updated Dec 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2004-00119 Issued in NC
Legal business name
GROVE PARK PEDIATRICS
Practice address
113 Trail One
Burlington, NC 27215-5531
Phone
(336) 570-0354
Fax
(336) 570-0356
NPI assigned
Dec 1, 2008
Last updated
Dec 1, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2008

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

Authorized official

Name
Margarita Goldar, MDNPI 1588621544
Title
Owner
Phone
(336) 570-0354

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2004-00119 NC Primary

Addresses

Primary practice location

113 Trail One
Burlington, NC 27215-5531

Mailing address

113 Trail One
Burlington, NC 27215-5531
Phone (336) 570-0354

Other identifiers 1

IdentifierTypeStateIssuer
89137W6MedicaidNC

National Provider Directory

National Provider Directory

Locations

113 Trail One
Burlington, NC 27215
Phone (336) 570-0354

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1228089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228089600000",
    "number": "1275788416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 TRAIL ONE",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272155531",
            "telephone_number": "336-570-0354",
            "fax_number": "336-570-0356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 TRAIL ONE",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272155531",
            "telephone_number": "336-570-0354",
            "fax_number": "336-570-0356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROVE PARK PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-01",
        "last_updated": "2008-12-01",
        "status": "A",
        "authorized_official_last_name": "GOLDAR",
        "authorized_official_first_name": "MARGARITA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-570-0354",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2004-00119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89137W6",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2008; 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.