NPIMap

Organization Active NPI

Northwest Childrens & Adolescents Clinic

  • Pediatrics Physician
  • Boone, NC
National Provider Identifier
1295896132
Registry record updated Aug 22, 2020
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Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
NORTHWEST CHILDRENS & ADOLESCENTS CLINIC
Practice address
134 Doctors Dr
Boone, NC 28607-5000
Phone
(828) 265-2178
Fax
(828) 264-1637
NPI assigned
Dec 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Edith Kocis, M.D.
Title
Physician
Phone
(828) 265-2178

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X NC Primary

Addresses

Primary practice location

134 Doctors Dr
Boone, NC 28607-5000

Mailing address

134 Doctors Dr
Boone, NC 28607-5000
Phone (828) 265-2178

National Provider Directory

National Provider Directory

Locations

134 Doctors Dr
Boone, NC 28607
Phone (828) 265-2178

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295896132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 DOCTORS DR",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286075000",
            "telephone_number": "828-265-2178",
            "fax_number": "828-264-1637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 DOCTORS DR",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286075000",
            "telephone_number": "828-265-2178",
            "fax_number": "828-264-1637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST CHILDRENS & ADOLESCENTS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOCIS",
        "authorized_official_first_name": "EDITH",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "828-265-2178",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boone, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.