Polaris Pediatrics Inc

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

35039260 Issued in OH

Legal business name

POLARIS PEDIATRICS INC

Practice address

8947 Antares Avenue
Columbus, OH 43240-2012

Phone

(614) 437-5600

Fax

(614) 985-1499

NPI assigned

Mar 28, 2011

Last updated

Jul 7, 2011By 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

Bruce Robert Mirvis, M.D.NPI 1568434835

Title

Owner

Phone

(614) 437-5600

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bruce Mirvis, MD Other name

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.

• Bruce Robert Mirvis, M.D.

  • Pediatrics Physician
  • Columbus, OH
  • NPI 1568434835
  NPD Authorized official

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

{
    "created_epoch": "1301270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309996800000",
    "number": "1609175819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8947 ANTARES AVENUE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432402012",
            "telephone_number": "614-437-5600",
            "fax_number": "614-985-1499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8947 ANTARES AVENUE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432402012",
            "telephone_number": "614-437-5600",
            "fax_number": "614-985-1499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLARIS PEDIATRICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-28",
        "last_updated": "2011-07-07",
        "status": "A",
        "authorized_official_last_name": "MIRVIS",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "614-437-5600",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35039260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0345086",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bruce Mirvis, MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Roxana Polanco
• Polaris Eye Care
• Polaris Laboratories LLC
• Polaris Orthodontic Center Amin Mason DDS, LLC
• Polaris Park Oh Dentist LLC
• Polaris Pharmacy Services of Ohio LLC
• Constance Polhamus, RN
• Michael C. Poliner, MD
• Heather Englund Poling
• Holly Anne Poling, APRN-CNP

• Pediatrics Physician in Columbus, OH
• Providers in Columbus, OH by specialty
• Pediatrics Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2011; 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.