NPIMap

Organization Active NPI

Peninsula Childrens Clinic Inc

  • Clinic/Center
  • Port Angeles, WA
National Provider Identifier
1528025293
Registry record updated Nov 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
601481297 Issued in WA
Legal business name
PENINSULA CHILDRENS CLINIC INC
Practice address
902 E Caroline
Port Angeles, WA 98362
Phone
(360) 457-8578
Fax
(360) 457-4841
NPI assigned
Apr 27, 2006
Last updated
Nov 5, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2015

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

Authorized official

Name
Dr. Jeffrey Charles Weller, MDNPI 1457302630
Title
Pediatrician
Phone
(360) 457-8578

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 601481297 WA Primary

Addresses

Primary practice location

902 E Caroline
Port Angeles, WA 98362

Mailing address

902 E Caroline
Port Angeles, WA 98362
Phone (360) 457-8578

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1146096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446681600000",
    "number": "1528025293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 E CAROLINE",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "98362",
            "telephone_number": "360-457-8578",
            "fax_number": "360-457-4841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 E CAROLINE",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "98362",
            "telephone_number": "360-457-8578",
            "fax_number": "360-457-4841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA CHILDRENS CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-27",
        "last_updated": "2015-11-05",
        "status": "A",
        "authorized_official_last_name": "WELLER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "PEDIATRICIAN",
        "authorized_official_telephone_number": "360-457-8578",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WA",
            "license": "601481297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Angeles, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2015; 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.