NPIMap

Organization Active NPI

Eagan Valley Pediatrics, P.a.

  • Clinic/Center
  • Apple Valley, MN
National Provider Identifier
1528050119
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
EAGAN VALLEY PEDIATRICS, P.A.
Practice address
14135 Cedar Ave
Suite 100
Apple Valley, MN 55124-4522
Phone
(952) 432-4373
Fax
(952) 997-5679
NPI assigned
Aug 19, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
James E Dufort, M.D.NPI 1376535732
Title
President
Phone
(952) 432-4373

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

14135 Cedar Ave
Suite 100
Apple Valley, MN 55124-4522

Mailing address

14135 Cedar Ave
Suite 100
Apple Valley, MN 55124-4522
Phone (952) 432-4373

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D0978828Eagan Valley Pediatrics14135 Cedar Ave, Apple Valley, MN 55124ComplianceOct 29, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

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": "1124409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1528050119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14135 CEDAR AVE",
            "address_2": "SUITE 100",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551244522",
            "telephone_number": "952-432-4373",
            "fax_number": "952-997-5679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14135 CEDAR AVE",
            "address_2": "SUITE 100",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551244522",
            "telephone_number": "952-432-4373",
            "fax_number": "952-997-5679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGAN VALLEY PEDIATRICS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DUFORT",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "952-432-4373",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.