NPIMap

Organization Active NPI

TLC Pediatrics, PC

  • Primary Care Clinic/Center
  • Sedalia, MO
National Provider Identifier
1578665451
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
115544 Issued in MO
Legal business name
TLC PEDIATRICS, PC
Practice address
2925 Clinton Rd
Sedalia, MO 65301-7915
Phone
(660) 829-5852
Fax
(660) 829-5854
NPI assigned
Sep 2, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Assad U Shaffiey, MDNPI 1710928593
Title
President
Phone
(660) 829-5852

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
Primary Care Clinic/Center 261QP2300X 115544 MO Primary

Addresses

Primary practice location

2925 Clinton Rd
Sedalia, MO 65301-7915

Mailing address

2925 Clinton Rd
Sedalia, MO 65301-7915
Phone (660) 829-5852

Other identifiers 7

IdentifierTypeStateIssuer
1200057OtherMOUHC
18833MedicaidMO
G85947OtherMOMERCY
372430MedicaidMO
9518MedicaidMO
392869OtherMOHEALTHLINK/FREEDOM NET
25282044OtherMOBCBS

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": "1157155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1578665451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CLINTON RD",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653017915",
            "telephone_number": "660-829-5852",
            "fax_number": "660-829-5854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2925 CLINTON RD",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653017915",
            "telephone_number": "660-829-5852",
            "fax_number": "660-829-5854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TLC PEDIATRICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHAFFIEY",
        "authorized_official_first_name": "ASSAD",
        "authorized_official_middle_name": "U",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "660-829-5852",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MO",
            "license": "115544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "1200057",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18833",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY",
            "identifier": "G85947",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "372430",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9518",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK/FREEDOM NET",
            "identifier": "392869",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "25282044",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sedalia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.