Columbia Pediatris, P.C.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

19061 Issued in MS

Legal business name

COLUMBIA PEDIATRIS, P.C.

Practice address

1212 Broad St
Columbia, MS 39429-3114

Phone

(601) 444-9266

Fax

(601) 444-9267

NPI assigned

Oct 22, 2007

Last updated

Oct 22, 2007By 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. Abiodun Fatima Balogun, MD

Title

President/Owner

Phone

(601) 444-9266

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193011200000",
    "number": "1447449806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1055",
            "city": "PICAYUNE",
            "state": "MS",
            "postal_code": "394661055",
            "telephone_number": "601-444-9266",
            "fax_number": "601-444-9267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 BROAD ST",
            "city": "COLUMBIA",
            "state": "MS",
            "postal_code": "394293114",
            "telephone_number": "601-444-9266",
            "fax_number": "601-444-9267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA PEDIATRIS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-22",
        "last_updated": "2007-10-22",
        "status": "A",
        "authorized_official_last_name": "BALOGUN",
        "authorized_official_first_name": "ABIODUN",
        "authorized_official_middle_name": "FATIMA",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "601-444-9266",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "19061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cody Caston Choate, D.O.
• Steven Alan Clement, D.M.D.
• Columbia Community Care Center LLC (The Myrtles Nursing Center)
• Columbia Discount Drugs, Inc
• Columbia Family Dental LLC
• Columbia Rehabilitation and Healthcare Center, LLC
• Columbia Rehabilitation LLC
• Columbia School District
• Compassionate Heart Personal Care & Respite Services LLC
• Cook and Fortenberry Pharmacy

• Pediatrics Physician in Columbia, MS
• Providers in Columbia, MS by specialty
• Pediatrics Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2007; 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.