Pediatric Behavioral Medicine, Inc

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

MD2008-0370 Issued in NM

Legal business name

PEDIATRIC BEHAVIORAL MEDICINE, INC

Practice address

2407 W Picacho Ave
A104
Las Cruces, NM 88007-4124

Phone

(575) 805-0849

Fax

(575) 541-3617

NPI assigned

Apr 3, 2012

Last updated

Feb 26, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

James W Martin, MD

Title

President

Phone

(575) 805-0849

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1333411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361836800000",
    "number": "1538425541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2407 W PICACHO AVE",
            "address_2": "A104",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880074124",
            "telephone_number": "575-805-0849",
            "fax_number": "575-541-3617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2407 W PICACHO AVE",
            "address_2": "A104",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880074124",
            "telephone_number": "575-805-0849",
            "fax_number": "575-541-3617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC BEHAVIORAL MEDICINE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-03",
        "last_updated": "2013-02-26",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "575-805-0849",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NM",
            "license": "MD2008-0370",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NM",
            "license": "MD2008-0370",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NM",
            "license": "MD2008-0370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Ruth Pearlstein, LMHC
• Andrew Stephen Pearson, MD
• Carlos Peay, C.PED
• Katherine Peck Louise Peck, RN, CNS, PNP
• Jaya Bharathi Peddi, M.D.
• Pediatric Dental Specialist of New Mexico LLC
• Elizabeth Pedraza
• Priscilla Pedraza, FNP-C
• Peds Tots to Teens LLC
• Talia Y Peiffer-Lapid, MA, CCC-SLP

• Child & Adolescent Psychiatry Physician in Las Cruces, NM
• Providers in Las Cruces, NM by specialty
• Child & Adolescent Psychiatry Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 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.