NPIMap

Organization Active NPI

Pediatric Associates of Charlottesville

Doing business as Kelson Physician Partners of Charlottesville

  • Pediatrics Physician
  • Charlottesville, VA
National Provider Identifier
1528178787
Registry record updated Nov 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PEDIATRIC ASSOCIATES OF CHARLOTTESVILLE
Doing business as
Kelson Physician Partners of Charlottesville
Practice address
1011 E Jefferson St
Charlottesville, VA 22902-5354
Phone
(434) 296-9161
Fax
(434) 296-1036
NPI assigned
Aug 30, 2006
Last updated
Nov 1, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2013

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

Authorized official

Name
Mr. Paul Wisman Jr.NPI 1235115650
Title
Physician
Phone
(434) 296-9161

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
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

1011 E Jefferson St
Charlottesville, VA 22902-5354

Mailing address

1011 E Jefferson St
Charlottesville, VA 22902-5354
Phone (434) 296-9161

Other names 1

  • Kelson Physician Partners of Charlottesville Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kelson Physician Partners of Charlottesville2 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.

Locations

1522 Insurance Ln
#A
Charlottesville, VA 22911
Phone (434) 974-9600

1011 E Jefferson St
Charlottesvle, VA 22902
Phone (434) 296-9161

1522 Insurance Ln
Charlottesvle, VA 22911

2411 Ivy Rd
Charlottesvle, VA 22903
Phone (434) 296-8300

71 Jefferson Ct
Zion Crossroads, VA 22942

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383264000000",
    "number": "1528178787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 E JEFFERSON ST",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229025354",
            "telephone_number": "434-296-9161",
            "fax_number": "434-296-1036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 E JEFFERSON ST",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229025354",
            "telephone_number": "434-296-9161",
            "fax_number": "434-296-1036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ASSOCIATES OF CHARLOTTESVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2013-11-01",
        "status": "A",
        "authorized_official_last_name": "WISMAN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "434-296-9161",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kelson Physician Partners of Charlottesville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlottesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2013; 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.