NPIMap

Organization Active NPI

Kidworx Pediatric Center, LLC

  • Clinic/Center
  • Horsham, PA
National Provider Identifier
1477805737
Registry record updated Oct 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
MD063137L Issued in PA
Legal business name
KIDWORX PEDIATRIC CENTER, LLC
Practice address
3 Village Rd Ste 100
Horsham, PA 19044-3812
Phone
(215) 830-8870
NPI assigned
Oct 11, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2012

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

Authorized official

Name
Dr. Maria Mahoney, MD
Title
Owner
Phone
(215) 830-8870

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X MD063137L PA Primary

Addresses

Primary practice location

3 Village Rd Ste 100
Horsham, PA 19044-3812

Mailing address

3 Village Rd Ste 100
Horsham, PA 19044-3812
Phone (215) 830-8870

Other identifiers 1

IdentifierTypeStateIssuer
0017043070004MedicaidPA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1349913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349913600000",
    "number": "1477805737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 VILLAGE RD STE 100",
            "city": "HORSHAM",
            "state": "PA",
            "postal_code": "190443812",
            "telephone_number": "215-830-8870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 VILLAGE RD STE 100",
            "city": "HORSHAM",
            "state": "PA",
            "postal_code": "190443812",
            "telephone_number": "215-830-8870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDWORX PEDIATRIC CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-11",
        "last_updated": "2012-10-11",
        "status": "A",
        "authorized_official_last_name": "MAHONEY",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-830-8870",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "PA",
            "license": "MD063137L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017043070004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Horsham, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2012; 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.