Dothan Pediatric Clinic, P. a.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

DOTHAN PEDIATRIC CLINIC, P. A.

Doing business as

Enterprise Pediatric Clinic

Practice address

526 Boll Weevil Cir
Enterprise, AL 36330-4012

Phone

(334) 308-1166

NPI assigned

Jul 22, 2021

Last updated

Jul 22, 2021By 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

Gina Tolar

Title

Insurance & Collections Supervisor

Phone

(334) 793-1881

Specialties & licenses 3

Addresses

Other names 1

• Enterprise Pediatric Clinic Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Dothan Pediatric Clinic P a3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Dothan Pediatric Clinic, P. a.

  • Pediatrics Physician
  • Dothan, AL
  • NPI 1376508788
  NPD tax ID
• Dothan Pediatric Clinic, P. a.

  dba Dothan Pediatric Subspecialty Clinic

  • Pediatrics Physician
  • Dothan, AL
  • NPI 1457027955
  NPD tax ID

Locations

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

{
    "created_epoch": "1626912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626912000000",
    "number": "1447823877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 CLINIC DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363031980",
            "telephone_number": "334-793-1881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "526 BOLL WEEVIL CIR",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363304012",
            "telephone_number": "334-308-1166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOTHAN PEDIATRIC CLINIC, P. A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-22",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A",
        "authorized_official_last_name": "TOLAR",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "INSURANCE & COLLECTIONS SUPERVISOR",
        "authorized_official_telephone_number": "334-793-1881"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Enterprise Pediatric Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pediatrics Physician in Enterprise, AL
• Providers in Enterprise, AL by specialty
• Pediatrics Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.