Suburban Pediatric Clinic, Inc

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

SUBURBAN PEDIATRIC CLINIC, INC

Doing business as

Suburban Pediatrics

Practice address

3396 Cloverleaf Pkwy
Kannapolis, NC 28083-6992

Phone

(704) 403-7740

Fax

(704) 403-7750

NPI assigned

Apr 4, 2006

Organization subpart

No

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

Authorized official

Name

Thomas F Laymon

Title

Sr. Vice President

Phone

(704) 403-2276

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Suburban Pediatrics Doing business as

Tax ID family

Gregory P Guerrieromd2 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.

• Suburban Pediatric Clinic, Inc.

  • Pediatrics Physician
  • Davidson, NC
  • NPI 1447303680
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Suburban Pediatric Clinic, Inc.

  • Pediatrics Physician
  • Davidson, NC
  • NPI 1447303680
  NPPES parent name

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453766400000",
    "number": "1487616520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3396 CLOVERLEAF PKWY",
            "city": "KANNAPOLIS",
            "state": "NC",
            "postal_code": "280836992",
            "telephone_number": "704-403-7740",
            "fax_number": "704-403-7750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3396 CLOVERLEAF PKWY",
            "city": "KANNAPOLIS",
            "state": "NC",
            "postal_code": "280836992",
            "telephone_number": "704-403-7740",
            "fax_number": "704-403-7750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBURBAN PEDIATRIC CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-04",
        "last_updated": "2016-01-26",
        "status": "A",
        "authorized_official_last_name": "LAYMON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "SR. VICE PRESIDENT",
        "authorized_official_telephone_number": "704-403-2276"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5906978",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "896408",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6901491",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP ID",
            "identifier": "01491",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Suburban Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Miriam Angela Stilwell, PTA
• Emmett Stokes
• Chelsea Tysinger Stone, MOT, OTR/L
• Jared Stone, BS, COTA/L
• Lindsay Christine Stowers
• Russell Raymond Suda Sr., MD
• John Lance Sullivan
• Sycamore Counseling Center PLLC
• Synapse Wellness & Counseling
• Synergy Healthcare USA LLC

• Pediatrics Physician in Kannapolis, NC
• Providers in Kannapolis, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2016; 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.