NPIMap

Organization Active NPI

Kidshealth Pediatrics PLLC(Glendale)

  • Pediatrics Physician
  • Glendale, AZ
National Provider Identifier
1336767342
Registry record updated Jul 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
KIDSHEALTH PEDIATRICS PLLC(GLENDALE)
Practice address
5750 W Thunderbird Rd Ste F620
Glendale, AZ 85306-4690
Phone
(602) 374-3396
NPI assigned
Jul 7, 2020
Last updated
Jul 7, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
KIDSHEALTH PEDIATRICS, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 7, 2020

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

Authorized official

Name
Dr. Maria Louella Nabong, MDNPI 1275547150
Title
Physician/Owner
Phone
(602) 374-3396

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

5750 W Thunderbird Rd Ste F620
Glendale, AZ 85306-4690

Mailing address

5425 E Bell Rd Ste 131
Scottsdale, AZ 85254-6010
Phone (602) 374-3396

Other names 1

  • Kidshealth Pediatrics, PLLC(Glendale) Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D2176753Kidshealth Pediatrics5750 W Thunderbird Rd Suite F620, Glendale, AZ 85306Certificate of waiverDec 22, 2027

National Provider Directory

National Provider Directory
Tax ID family
Kidshealth Pediatrics PLLC3 organizations share this tax ID, including this one
Part of
Kidshealth Pediatrics PLLC

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

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": "1594080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594080000000",
    "number": "1336767342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5425 E BELL RD STE 131",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852546010",
            "telephone_number": "602-374-3396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5750 W THUNDERBIRD RD STE F620",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064690",
            "telephone_number": "602-374-3396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDSHEALTH PEDIATRICS PLLC(GLENDALE)",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KIDSHEALTH PEDIATRICS, PLLC",
        "enumeration_date": "2020-07-07",
        "last_updated": "2020-07-07",
        "certification_date": "2020-07-07",
        "status": "A",
        "authorized_official_last_name": "NABONG",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "LOUELLA",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "602-374-3396",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kidshealth Pediatrics, PLLC(Glendale)",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.