Pediatric Care Clinic

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

10074 Issued in MS

Legal business name

PEDIATRIC CARE CLINIC

Practice address

421 River Rd
Picayune, MS 39466-3160

Phone

(985) 726-2655

Fax

(985) 643-9808

NPI assigned

Jun 4, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Ashraf Tabatabaii, MDNPI 1679726905

Title

Owner

Phone

(985) 726-2655

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ashraf Tabatabaii, MD

  • Pediatrics Physician
  • Picayune, MS
  • NPI 1679726905
  NPD (past) Authorized official

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

{
    "created_epoch": "1244073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244073600000",
    "number": "1346476322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 RIVER RD",
            "city": "PICAYUNE",
            "state": "MS",
            "postal_code": "394663160",
            "telephone_number": "985-726-2655",
            "fax_number": "985-643-9808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 RIVER RD",
            "city": "PICAYUNE",
            "state": "MS",
            "postal_code": "394663160",
            "telephone_number": "985-726-2655",
            "fax_number": "985-643-9808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC CARE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-04",
        "last_updated": "2009-06-04",
        "status": "A",
        "authorized_official_last_name": "TABATABAII",
        "authorized_official_first_name": "ASHRAF",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "985-726-2655",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "10074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09015403",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pathway Diagnostics LLC
• Pathways to Behavioral Support LLC
• Annie Deloris Patrick
• Pearl River Emergency Group LLC
• Pearl River Rehab, P.a.
• Pelican Urgent Care, Ms, LLC
• Carla Donnell Penton, FNP
• Victoria-Leigh Elizabeth Perkins, RBT
• Personal Pediatric Care of Picayune LLC
• Clara Annette Phillippe

• Pediatrics Physician in Picayune, MS
• Providers in Picayune, MS by specialty
• Pediatrics Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2009; 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.