Dothan Pediatric Clinic, P. a.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

DOTHAN PEDIATRIC CLINIC, P. A.

Doing business as

Dothan Pediatric Subspecialty Clinic

Practice address

5565 Montgomery Hwy
Dothan, AL 36303-1552

Phone

(334) 699-3733

NPI assigned

Aug 17, 2021

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 & Collection Supervisor

Phone

(334) 793-1881

Specialties & licenses 7

Addresses

Other names 1

• Dothan Pediatric Subspecialty 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 Enterprise Pediatric Clinic

  • Pediatrics Physician
  • Enterprise, AL
  • NPI 1447823877
  NPD tax ID

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

{
    "created_epoch": "1629158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629158400000",
    "number": "1457027955",
    "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": "5565 MONTGOMERY HWY",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363031552",
            "telephone_number": "334-699-3733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOTHAN PEDIATRIC CLINIC, P. A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-17",
        "last_updated": "2021-08-17",
        "certification_date": "2021-07-22",
        "status": "A",
        "authorized_official_last_name": "TOLAR",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "INSURANCE & COLLECTION 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": "2080P0205X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080S0012X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "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": "Dothan Pediatric Subspecialty Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dothan Neurology Clinic, PC
• Dothan OBGYN, Inc.
• Dothan Ophthalmology
• Dothan Pain Center LLC
• Dothan Pediatric Clinic, P. a.
• Dothan Pharmacy LLC (Dothan Pharmacy)
• Dothan Primary Care LLC (Dothan Family Practice)
• Dothan Professional Counseling Services
• Dothan Psychiatric, PC
• Dothan Psychiatry & Sleep Disorders Medicine, PC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.