Pediatrix Medical Group Neonatology and Pediatric Intensive Care Speci

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

Legal business name

PEDIATRIX MEDICAL GROUP NEONATOLOGY AND PEDIATRIC INTENSIVE CARE SPECI

Practice address

1301 Concord Ter
Sunrise, FL 33323-2843

Phone

(954) 384-0175

Fax

(954) 851-1948

NPI assigned

Sep 17, 2006

Last updated

Nov 5, 2024By 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. Karin Johnson

Title

President

Phone

(800) 243-3839

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730764800000",
    "number": "1376640078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4991 LAKE BROOK DR",
            "address_2": "SUITE 300",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230609293",
            "telephone_number": "804-346-3535",
            "fax_number": "804-253-0408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 CONCORD TER",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232843",
            "telephone_number": "954-384-0175",
            "fax_number": "954-851-1948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIX MEDICAL GROUP NEONATOLOGY AND PEDIATRIC INTENSIVE CARE SPECI",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-17",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KARIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "800-243-3839",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3069683",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pediatric Theraplay, LLC
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• Pediatrix Cardiology of Springfield PC
• Pediatrix Management Services, Inc.
• Pediatrix Medical Group Ambulatory Services of TN, PLLC
• Pediatrix Medical Group of Alabama, Inc.
• Pediatrix Medical Group of California, a Professional Corp
• Pediatrix Medical Group of California, a Professional Corporation
• Pediatrix Medical Group of Florida Inc
• Pediatrix Medical Group of Georgia, P.C. (Pediatrix Medical Group of Central Georgia)

• Neonatal-Perinatal Medicine Physician in Sunrise, FL
• Providers in Sunrise, FL by specialty
• Neonatal-Perinatal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; 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.