Suburban Pediatric Clinic, Inc.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

SUBURBAN PEDIATRIC CLINIC, INC.

Doing business as

Suburban Pediatric Clinic - Davidson

Practice address

2101 Shiloh Church Rd
Suite 101
Davidson, NC 28036-7603

Phone

(704) 439-3700

Fax

(704) 439-3729

NPI assigned

Jan 19, 2007

Organization subpart

Yes

Parent organization

SUBURBAN PEDIATRIC CLINIC, INC.As reported in NPPES

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

Authorized official

Name

Thomas F Laymon

Title

Sr. Vice President

Phone

(704) 403-2276

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Suburban Pediatric Clinic - Davidson Doing business as

Tax ID family

Suburban Pediatric Clin2 organizations share this tax ID, including this one

Part of

Suburban Pediatric Clin

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Suburban Pediatric Clinic, Inc

  dba Suburban Pediatrics

  • Pediatrics Physician
  • Kannapolis, NC
  • NPI 1487616520
  NPD tax ID

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Suburban Pediatric Clinic, Inc

  dba Suburban Pediatrics

  • Pediatrics Physician
  • Kannapolis, NC
  • NPI 1487616520
  NPPES parent name

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453766400000",
    "number": "1447303680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 SHILOH CHURCH RD",
            "address_2": "SUITE 101",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280367603",
            "telephone_number": "704-439-3700",
            "fax_number": "704-439-3729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 SHILOH CHURCH RD",
            "address_2": "SUITE 101",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280367603",
            "telephone_number": "704-439-3700",
            "fax_number": "704-439-3729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBURBAN PEDIATRIC CLINIC, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUBURBAN PEDIATRIC CLINIC, INC.",
        "enumeration_date": "2007-01-19",
        "last_updated": "2016-01-26",
        "status": "A",
        "authorized_official_last_name": "LAYMON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "SR. VICE PRESIDENT",
        "authorized_official_telephone_number": "704-403-2276"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5903375",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5906983",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP ID",
            "identifier": "01491",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "896408",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Suburban Pediatric Clinic - Davidson",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Springhealth Behavioral Health and Integrated Care North Carolina, LLC
• Fallon Stapleton, LCSW
• William David Staton, PH.D.
• Jessica Stoiber, RD
• Stone Institute of the Carolinas LLC
• Amy Kathleen Conn Suggs, CCC-SLP
• Nancy B. Tarte, MD
• Heather Taylor Griffith, L.C.S.W.
• Tei- Davidson OD (The Eye Institute OD, PA)
• Nilima Pareshkumar Thakkar, MD

• Pediatrics Physician in Davidson, NC
• Providers in Davidson, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2016; 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.