NPIMap

Organization Active NPI

Pediatric Critical Care Associates PS

  • Pediatric Critical Care Medicine Physician
  • Spokane, WA
National Provider Identifier
1548210719
Registry record updated Jul 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
Legal business name
PEDIATRIC CRITICAL CARE ASSOCIATES PS
Practice address
101 W 8TH Ave
Spokane, WA 99204-2307
Phone
(509) 474-7461
Fax
(509) 474-5233
NPI assigned
May 11, 2006
Last updated
Jul 12, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2007

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

Authorized official

Name
Dr. Peter W Graves, MDNPI 1932151768
Title
Secretery Tresurer
Phone
(509) 474-5233

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU
Pediatric Critical Care Medicine Physician 2080P0203X NU Primary

Addresses

Primary practice location

101 W 8TH Ave
Spokane, WA 99204-2307

Mailing address

PO Box 84301
Seattle, WA 98124-5601
Phone (509) 926-1770

Other identifiers 2

IdentifierTypeStateIssuer
7055130MedicaidWA
7108640MedicaidWA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184198400000",
    "number": "1548210719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 84301",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981245601",
            "telephone_number": "509-926-1770",
            "fax_number": "509-228-9542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W 8TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042307",
            "telephone_number": "509-474-7461",
            "fax_number": "509-474-5233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC CRITICAL CARE ASSOCIATES PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2007-07-12",
        "status": "A",
        "authorized_official_last_name": "GRAVES",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "SECRETERY TRESURER",
        "authorized_official_telephone_number": "509-474-5233",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7055130",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7108640",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; 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.