NPIMap

Organization Active NPI

Kidz Paradise Pediatrics

  • Pediatrics Physician
  • Lima, OH
National Provider Identifier
1306138458
Registry record updated May 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35.077031 Issued in OH
Legal business name
KIDZ PARADISE PEDIATRICS
Practice address
3275 W Elm St
Lima, OH 45805-2518
Phone
(419) 999-9004
Fax
(419) 999-9006
NPI assigned
May 9, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2011

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

Authorized official

Name
Dr. Tilly Effie Duncan-Sampson
Title
Owner
Phone
(419) 999-9004

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 35.077031 OH Primary

Addresses

Primary practice location

3275 W Elm St
Lima, OH 45805-2518

Mailing address

3275 W Elm St
Lima, OH 45805-2518
Phone (419) 999-9004

Other identifiers 1

IdentifierTypeStateIssuer
2136914MedicaidOH

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1304899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304899200000",
    "number": "1306138458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3275 W ELM ST",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458052518",
            "telephone_number": "419-999-9004",
            "fax_number": "419-999-9006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3275 W ELM ST",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458052518",
            "telephone_number": "419-999-9004",
            "fax_number": "419-999-9006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDZ PARADISE PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-09",
        "last_updated": "2011-05-09",
        "status": "A",
        "authorized_official_last_name": "DUNCAN-SAMPSON",
        "authorized_official_first_name": "TILLY",
        "authorized_official_middle_name": "EFFIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "419-999-9004",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.077031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2136914",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lima, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2011; 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.