NPIMap

Organization Active NPI

Night Light Pediatrics LLC

  • Pediatric Adolescent Medicine Physician
  • St George, UT
National Provider Identifier
1295855914
Registry record updated Jul 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
88-178110-1205 Issued in UT
Legal business name
NIGHT LIGHT PEDIATRICS LLC
Practice address
1240 E 100 S Ste 14
St George, UT 84790-3005
Phone
(435) 628-8034
NPI assigned
Mar 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2007

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

Authorized official

Name
Dr. Jerry D Twiggs, M.D.NPI 1972583680
Title
President
Phone
(435) 628-8034

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
Pediatric Adolescent Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080A0000X 88-178110-1205 UT Primary

Addresses

Primary practice location

1240 E 100 S Ste 14
St George, UT 84790-3005

Mailing address

1240 E 100 S Ste 14
St George, UT 84790-3005
Phone (435) 628-8034

Other identifiers 1

IdentifierTypeStateIssuer
09165MedicaidUT

National Provider Directory

National Provider Directory

Locations

1240 E 100 S
Ste 14
St George, UT 84790
Phone (435) 628-8034

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185321600000",
    "number": "1295855914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 E 100 S STE 14",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847903005",
            "telephone_number": "435-628-8034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 E 100 S STE 14",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847903005",
            "telephone_number": "435-628-8034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIGHT LIGHT PEDIATRICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2007-07-25",
        "status": "A",
        "authorized_official_last_name": "TWIGGS",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "435-628-8034",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "UT",
            "license": "88-178110-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09165",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2007; 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.