NPIMap

Organization Active NPI

Children's Specialists of San Diego - Div of Neph

  • Pediatric Nephrology Physician
  • San Diego, CA
National Provider Identifier
1538226006
Registry record updated Apr 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nephrology PhysicianTaxonomy code 2080P0210X
Legal business name
CHILDREN'S SPECIALISTS OF SAN DIEGO - DIV OF NEPH
Practice address
8110 Birmingham Way
Building 28
San Diego, CA 92123-2758
Phone
(858) 966-8052
NPI assigned
Jan 3, 2007
Last updated
Apr 22, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
CHILDREN'S SPECIALISTS OF SAN DIEGOAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 22, 2008

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

Authorized official

Name
Herbert C. Kimmons Jr., M.D.NPI 1023189784
Title
President
Phone
(858) 966-8567

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU
Pediatric Nephrology Physician 2080P0210X NU Primary

Addresses

Primary practice location

8110 Birmingham Way
Building 28
San Diego, CA 92123-2758

Mailing address

3860 Calle Fortunada
Suite 210
San Diego, CA 92123-4800
Phone (858) 309-6303

Other identifiers 1

IdentifierTypeStateIssuer
GR0068869MedicaidCA

Other names 1

  • Children's Associated Medical Group Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Children's Specialists of San Diego - Div of Ortho24 organizations share this tax ID, including this one
Part of
Children's Specialists of San Diego - Div of Ortho

Other organizations with this tax ID 23

Organizations that report the same tax identification number in the National Provider Directory.

View all 23

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": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208822400000",
    "number": "1538226006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3860 CALLE FORTUNADA",
            "address_2": "SUITE 210",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234800",
            "telephone_number": "858-309-6303",
            "fax_number": "858-309-6301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8110 BIRMINGHAM WAY",
            "address_2": "BUILDING 28",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232758",
            "telephone_number": "858-966-8052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S SPECIALISTS OF SAN DIEGO - DIV OF NEPH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHILDREN'S SPECIALISTS OF SAN DIEGO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2008-04-22",
        "status": "A",
        "authorized_official_last_name": "KIMMONS",
        "authorized_official_first_name": "HERBERT",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-966-8567",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0068869",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Children's Associated Medical Group",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.