Sunrise Pediatrics PLLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

38144 Issued in KY

Legal business name

SUNRISE PEDIATRICS PLLC

Practice address

3602 Cumberland Ave
Suite B103
Middlesboro, KY 40965-2614

Phone

(606) 248-6999

NPI assigned

Apr 8, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Wael I Ghanim, M.D.

Title

Owner

Phone

(606) 248-6999

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211932800000",
    "number": "1386817773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 546",
            "city": "MIDDLESBORO",
            "state": "KY",
            "postal_code": "409650546",
            "telephone_number": "606-248-6999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3602 CUMBERLAND AVE",
            "address_2": "SUITE B103",
            "city": "MIDDLESBORO",
            "state": "KY",
            "postal_code": "409652614",
            "telephone_number": "606-248-6999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNRISE PEDIATRICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-08",
        "last_updated": "2008-05-28",
        "status": "A",
        "authorized_official_last_name": "GHANIM",
        "authorized_official_first_name": "WAEL",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "606-248-6999",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "38144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Sprinkles, PHARMD
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• Lovie A Stallworth, M.D.
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• James L Taylor, D.C.
• Jason Stuart Taylor, D.C.
• Kimberly Marie Taylor, D.C.

• Pediatrics Physician in Middlesboro, KY
• Providers in Middlesboro, KY by specialty
• Pediatrics Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2008; 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.