Organization Active NPI

Leah Botimer

  • Pediatrics Physician
  • Redlands, CA
National Provider Identifier
1356710495
Registry record updated Sep 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
NP95002812 Issued in CA
Legal business name
LEAH BOTIMER
Practice address
101 E Redlands Blvd
Redlands, CA 92373-4775
Phone
(909) 792-8866
Fax
(909) 792-9395
NPI assigned
Sep 18, 2015
Last updated
Sep 18, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2015

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

Authorized official

Name
Allison Ealy Blackwell
Title
Assitant
Phone
(909) 792-8866

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X NP95002812 CA Primary

Addresses

Primary practice location

101 E Redlands Blvd
Redlands, CA 92373-4775

Mailing address

101 E Redlands Blvd
Redlands, CA 92373-4775
Phone (909) 792-8866

Other identifiers 1

IdentifierTypeStateIssuer
NP95002812OtherCANP LICENSE

National Provider Directory

National Provider Directory
Tax ID family
Cameo Carter MD 2 a Professional Corporation3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1442534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442534400000",
    "number": "1356710495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E REDLANDS BLVD",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734775",
            "telephone_number": "909-792-8866",
            "fax_number": "909-792-9395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E REDLANDS BLVD",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734775",
            "telephone_number": "909-792-8866",
            "fax_number": "909-792-9395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEAH BOTIMER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-18",
        "last_updated": "2015-09-18",
        "status": "A",
        "authorized_official_last_name": "BLACKWELL",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_middle_name": "EALY",
        "authorized_official_title_or_position": "ASSITANT",
        "authorized_official_telephone_number": "909-792-8866"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "NP95002812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP LICENSE",
            "identifier": "NP95002812",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2015; 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.