NPIMap

Organization Active NPI

Pediatric Associates, LLC

  • Primary Care Clinic/Center
  • Bristol, CT
National Provider Identifier
1295920015
Registry record updated Sep 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
1896539000 Issued in CT
Legal business name
PEDIATRIC ASSOCIATES, LLC
Practice address
10 N Main St
Bristol, CT 06010-8102
Phone
(860) 589-5230
Fax
(860) 589-5297
NPI assigned
Sep 14, 2007
Last updated
Sep 14, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2007

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

Authorized official

Name
Ms. Maria I Lopez
Title
Practice Manager
Phone
(860) 589-5238

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 1896539000 CT Primary

Addresses

Primary practice location

10 N Main St
Bristol, CT 06010-8102

Mailing address

10 N Main St
Bristol, CT 06010-8102
Phone (860) 589-5230

National Provider Directory

National Provider Directory

Locations

43 Enterprise Dr
Ste 1
Bristol, CT 06010

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22544/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 4

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": "1189728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189728000000",
    "number": "1295920015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 N MAIN ST",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060108102",
            "telephone_number": "860-589-5230",
            "fax_number": "860-589-5297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 N MAIN ST",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060108102",
            "telephone_number": "860-589-5230",
            "fax_number": "860-589-5297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-14",
        "last_updated": "2007-09-14",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "860-589-5238",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CT",
            "license": "1896539000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.