Jackson Pediatrics P.C.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2242A Issued in WY

Legal business name

JACKSON PEDIATRICS P.C.

Doing business as

Jackson Pediatrics PC

Practice address

557 E. Broadway
557 E. Broadway
Jackson, WY 83001-8300

Phone

(307) 733-4627

Fax

(307) 733-5184

NPI assigned

May 24, 2007

Organization subpart

No

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

Authorized official

Name

Dr. James R Little, M.D.

Title

Owner

Phone

(307) 733-4627

Specialties & licenses 1

Addresses

Other names 1

• Jackson Pediatrics PC Doing business as

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382572800000",
    "number": "1316158272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1029",
            "address_2": "557 E. BROADWAY",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830011029",
            "telephone_number": "307-733-4627",
            "fax_number": "307-733-5184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "557 E. BROADWAY",
            "address_2": "557 E. BROADWAY",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830018300",
            "telephone_number": "307-733-4627",
            "fax_number": "307-733-5184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON PEDIATRICS P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2013-10-24",
        "status": "A",
        "authorized_official_last_name": "LITTLE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "307-733-4627",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "WY",
            "license": "2242A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jackson Pediatrics PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pediatrics Physician in Jackson, WY
• Providers in Jackson, WY by specialty
• Pediatrics Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2013; 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.