Sugarloaf Pediatrics, PC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

205161 Issued in MA

Legal business name

SUGARLOAF PEDIATRICS, PC

Practice address

2 Park St
Unit 3
South Deerfield, MA 01373-1035

Phone

(413) 665-9111

Fax

(413) 665-9211

NPI assigned

Apr 3, 2009

Last updated

Mar 24, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Gina L O'Brien, MDNPI 1568426039

Title

Owner

Phone

(413) 665-9111

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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.

• Gina L. O'Brien, MD

  • Pediatrics Physician
  • Keene, NH
  • NPI 1568426039
  NPD Authorized official

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

{
    "created_epoch": "1238716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300924800000",
    "number": "1366684433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 PARK ST",
            "address_2": "UNIT 3",
            "city": "SOUTH DEERFIELD",
            "state": "MA",
            "postal_code": "013731035",
            "telephone_number": "413-665-9111",
            "fax_number": "413-665-9211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 PARK ST",
            "address_2": "UNIT 3",
            "city": "SOUTH DEERFIELD",
            "state": "MA",
            "postal_code": "013731035",
            "telephone_number": "413-665-9111",
            "fax_number": "413-665-9211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUGARLOAF PEDIATRICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-03",
        "last_updated": "2011-03-24",
        "status": "A",
        "authorized_official_last_name": "O'BRIEN",
        "authorized_official_first_name": "GINA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "413-665-9111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "205161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0103616",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kyle Spooner
• Katherine A Stemm
• Emily Stephens
• Joslin Tyler Stevens, LIC.,AC
• Sugarloaf Dental PC
• Sunmed Medical Systems LLC
• Penelope A Tarasuk, PHD
• Helkiah Tinkham
• Town of Conway (Conway Public Schools)
• Town of Deerfield (Deerfield Public Schools)

• Pediatrics Physician in South Deerfield, MA
• Providers in South Deerfield, MA by specialty
• Pediatrics Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2011; 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.