The Pediatric Center

Primary specialty

Pediatric Registered NurseTaxonomy code 163WP0200X

License

001946 Issued in CT

Legal business name

THE PEDIATRIC CENTER

Practice address

126 Morgan Street
Stamford, CT 09605

Phone

(203) 327-1055

Fax

(203) 323-6177

NPI assigned

Dec 16, 2011

Organization subpart

No

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

Authorized official

Name

Ms. Jill Beaudry

Title

Practice Administrator

Phone

(203) 327-1055

Specialties & licenses 2

Addresses

Other identifiers 1

Tax ID family

The Pediatric Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• The Pediatric Center, P.C.

  • Family Nurse Practitioner
  • Stamford, CT
  • NPI 1588778070
  NPD tax ID

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

{
    "created_epoch": "1323993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323993600000",
    "number": "1477822690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 MORGAN STREET",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "09605",
            "telephone_number": "203-327-1055",
            "fax_number": "203-323-6177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 MORGAN STREET",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "09605",
            "telephone_number": "203-327-1055",
            "fax_number": "203-323-6177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PEDIATRIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-16",
        "last_updated": "2011-12-16",
        "status": "A",
        "authorized_official_last_name": "BEAUDRY",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "203-327-1055",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Registered Nurse, Pediatrics",
            "state": "CT",
            "license": "001946",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CT",
            "license": "001903",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004129781",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• The Eyeglass Store
• The Garvin Group Dba Passport Health
• The Moody Dandelion
• The New England Center for Headache
• The Nutrition Attache
• The Pediatric Center, P.C.
• The Personalized Medicine Group of Connecticut
• The Physical Therapy Institute, LLC
• The Riverwalk Group
• The Rowan Center, Inc.

• Pediatric Registered Nurse in Stamford, CT
• Providers in Stamford, CT by specialty
• Pediatric Registered Nurse in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2011; 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.