NPIMap

Organization Active NPI

Pediatric Cardiology Assoc PA

Doing business as Congenital Heart

  • Pediatric Cardiology Physician
  • Scarborough, ME
National Provider Identifier
1346311925
Registry record updated Aug 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
014324 Issued in ME
Legal business name
PEDIATRIC CARDIOLOGY ASSOC PA
Doing business as
Congenital Heart
Practice address
71 US Route 1
Suite C
Scarborough, ME 04074-7173
Phone
(207) 883-5532
Fax
(207) 883-5552
NPI assigned
Nov 13, 2006
Last updated
Aug 28, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2017

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

Authorized official

Name
Dr. Jon Patrick Donnelly, MDNPI 1023102456
Title
President
Phone
(207) 883-5532

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
Pediatric Cardiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080P0202X 014324 ME Primary

Addresses

Primary practice location

71 US Route 1
Suite C
Scarborough, ME 04074-7173

Mailing address

71 US Route 1
Suite C
Scarborough, ME 04074-7173
Phone (207) 883-5532

Other names 1

  • CONGENITAL HEART Doing business as

National Provider Directory

National Provider Directory

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": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503878400000",
    "number": "1346311925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 US ROUTE 1",
            "address_2": "SUITE C",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747173",
            "telephone_number": "207-883-5532",
            "fax_number": "207-883-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 US ROUTE 1",
            "address_2": "SUITE C",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747173",
            "telephone_number": "207-883-5532",
            "fax_number": "207-883-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC CARDIOLOGY ASSOC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2017-08-28",
        "status": "A",
        "authorized_official_last_name": "DONNELLY",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "207-883-5532",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "ME",
            "license": "014324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CONGENITAL HEART",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Scarborough, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2017; 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.