Deshazo Medical

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

DESHAZO MEDICAL

Doing business as

4 Kids Pediatrics

Practice address

4387 Boulder Lake Cir
Vestavia, AL 35242-2116

Phone

(205) 492-0126

NPI assigned

Aug 13, 2019

Last updated

Aug 13, 2019By 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. Megan Deshazo, MD

Title

Chief Medical Officer

Phone

(205) 900-4321

Specialties & licenses 1

Addresses

Other names 1

• 4 Kids Pediatrics Doing business as

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

{
    "created_epoch": "1565654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565654400000",
    "number": "1386290781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4387 BOULDER LAKE CIR",
            "city": "VESTAVIA",
            "state": "AL",
            "postal_code": "352422116",
            "telephone_number": "205-492-0126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4387 BOULDER LAKE CIR",
            "city": "VESTAVIA",
            "state": "AL",
            "postal_code": "352422116",
            "telephone_number": "205-492-0126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESHAZO MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-13",
        "last_updated": "2019-08-13",
        "status": "A",
        "authorized_official_last_name": "DESHAZO",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "205-900-4321",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "4 Kids Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Caitlin Campbell Denton, LPC
• Lacey Denton, CRNA
• Laura Lynn Denver, PT
• Tyler Derrick, PHARMD
• Molleen Kofman Desai, CRNP
• Ashton Brooke Devore
• Melissa Ann Dixon, PHARMD
• DKM Pharmcare LLC
• Philip William Dockery, MD, MPH
• Richard Dodd, RPH

• Pediatrics Physician in Vestavia, AL
• Providers in Vestavia, AL by specialty
• Pediatrics Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2019; 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.