NPIMap

Organization Active NPI

Fremont Pediatric, Adolescent and Young Adult Medicine, LLC.

Doing business as Kid Care

  • Clinic/Center
  • Fremont, NE
National Provider Identifier
1558550368
Registry record updated Aug 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
18159 Issued in NE
Legal business name
FREMONT PEDIATRIC, ADOLESCENT AND YOUNG ADULT MEDICINE, LLC.
Doing business as
Kid Care
Practice address
220 E 22ND St
Fremont, NE 68025-2606
Phone
(402) 727-5500
Fax
(402) 727-6047
NPI assigned
Oct 17, 2007
Last updated
Aug 1, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2014

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

Authorized official

Name
Dr. Terry N Wooldridge, MDNPI 1750488284
Title
Owner
Phone
(402) 727-5500

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 18159 NE Primary

Addresses

Primary practice location

220 E 22ND St
Fremont, NE 68025-2606

Mailing address

220 E 22ND St
Fremont, NE 68025-2606
Phone (402) 727-5500

Other names 1

  • Kid Care Doing business as

National Provider Directory

National Provider Directory

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": "1192579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406851200000",
    "number": "1558550368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 E 22ND ST",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680252606",
            "telephone_number": "402-727-5500",
            "fax_number": "402-727-6047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 E 22ND ST",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680252606",
            "telephone_number": "402-727-5500",
            "fax_number": "402-727-6047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREMONT PEDIATRIC, ADOLESCENT AND YOUNG ADULT MEDICINE, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-17",
        "last_updated": "2014-08-01",
        "status": "A",
        "authorized_official_last_name": "WOOLDRIDGE",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-727-5500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NE",
            "license": "18159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kid Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fremont, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2014; 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.