NPIMap

Organization Active NPI

Perry Kids Pediatrics

  • Pediatric Medical Toxicology Physician
  • Perryville, MO
National Provider Identifier
1417123761
Registry record updated May 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Medical Toxicology PhysicianTaxonomy code 2080T0002X
License
MO105937 Issued in MO
Legal business name
PERRY KIDS PEDIATRICS
Practice address
210 Hospital LN
Perryville, MO 63775-1276
Phone
(573) 517-0999
Fax
(573) 517-0812
NPI assigned
May 7, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2008

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

Authorized official

Name
Dr. Bhargav M Kanani, M.D.
Title
Administrator
Phone
(573) 517-0999

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Medical Toxicology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080T0002X MO105937 MO Primary

Addresses

Primary practice location

210 Hospital LN
Perryville, MO 63775-1276

Mailing address

210 Hospital Lane
Perryville, MO 63670
UM
Phone (573) 517-0999

Other identifiers 1

IdentifierTypeStateIssuer
599297306MedicaidMO

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1210118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210118400000",
    "number": "1417123761",
    "addresses": [
        {
            "country_code": "UM",
            "country_name": "United States Minor Outlying Islands",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "210 HOSPITAL LANE",
            "city": "PERRYVILLE",
            "state": "MO",
            "postal_code": "63670",
            "telephone_number": "573-517-0999",
            "fax_number": "543-517-0812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 HOSPITAL LN",
            "city": "PERRYVILLE",
            "state": "MO",
            "postal_code": "637751276",
            "telephone_number": "573-517-0999",
            "fax_number": "573-517-0812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERRY KIDS PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-07",
        "last_updated": "2008-05-07",
        "status": "A",
        "authorized_official_last_name": "KANANI",
        "authorized_official_first_name": "BHARGAV",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "573-517-0999",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2080T0002X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Medical Toxicology",
            "state": "MO",
            "license": "MO105937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "599297306",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Perryville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 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.