NPIMap

Organization Active NPI

Pediatric Associates of Winchester

  • Pediatrics Physician
  • Winchester, VA
National Provider Identifier
1508974940
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PEDIATRIC ASSOCIATES OF WINCHESTER
Practice address
1002 Amherst St
BLDG C
Winchester, VA 22601-3323
Phone
(540) 662-3853
Fax
(540) 662-0336
NPI assigned
Aug 27, 2006
Last updated
Jun 18, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

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

Authorized official

Name
Bridget Denise Gibson
Title
Insurance Coordinator/Accts Receiva
Phone
(540) 662-3853

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

1002 Amherst St
BLDG C
Winchester, VA 22601-3323

Mailing address

1002 Amherst St
BLDG C
Winchester, VA 22601-3323
Phone (540) 662-3853

Other identifiers 1

IdentifierTypeStateIssuer
3810001745MedicaidWV

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1508974940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 AMHERST ST",
            "address_2": "BLDG C",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226013323",
            "telephone_number": "540-662-3853",
            "fax_number": "540-662-0336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 AMHERST ST",
            "address_2": "BLDG C",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226013323",
            "telephone_number": "540-662-3853",
            "fax_number": "540-662-0336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ASSOCIATES OF WINCHESTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-27",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "BRIDGET",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "INSURANCE COORDINATOR/ACCTS RECEIVA",
        "authorized_official_telephone_number": "540-662-3853"
    },
    "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": "3810001745",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; 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.