NPIMap

Organization Active NPI

Pediatric Healthcare, SC

  • Pediatrics Physician
  • Waukesha, WI
National Provider Identifier
1407807647
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PEDIATRIC HEALTHCARE, SC
Practice address
20611 Watertown Rd
C
Waukesha, WI 53186-1871
Phone
(262) 798-1810
Fax
(262) 798-2614
NPI assigned
May 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Beverly A Saran
Title
Manager
Phone
(262) 798-1810

Specialties & licenses 1

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

Addresses

Primary practice location

20611 Watertown Rd
C
Waukesha, WI 53186-1871

Mailing address

20611 Watertown Rd
C
Waukesha, WI 53186-1871
Phone (262) 798-1810

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407807647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20611 WATERTOWN RD",
            "address_2": "C",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531861871",
            "telephone_number": "262-798-1810",
            "fax_number": "262-798-2614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20611 WATERTOWN RD",
            "address_2": "C",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531861871",
            "telephone_number": "262-798-1810",
            "fax_number": "262-798-2614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC HEALTHCARE, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SARAN",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "262-798-1810"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.