NPIMap

Organization Active NPI

The Pediatric Promise Center LLC

  • Medical Specialty Clinic/Center
  • Rudy, AR
National Provider Identifier
1609256452
Registry record updated Jun 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
THE PEDIATRIC PROMISE CENTER LLC
Practice address
5653 Highway 282
Rudy, AR 72952-9008
Phone
(479) 806-4914
NPI assigned
Jun 8, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2015

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

Authorized official

Name
Mrs. Kala Dawn Price, M.S. CCC-SLPNPI 1023306719
Title
Incorporator
Phone
(479) 806-4914

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
Medical Specialty Clinic/Center 261QM2500X Primary

Addresses

Primary practice location

5653 Highway 282
Rudy, AR 72952-9008

Mailing address

5653 Highway 282
Rudy, AR 72952-9008
Phone (479) 806-4914

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1433721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433721600000",
    "number": "1609256452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5653 HIGHWAY 282",
            "city": "RUDY",
            "state": "AR",
            "postal_code": "729529008",
            "telephone_number": "479-806-4914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5653 HIGHWAY 282",
            "city": "RUDY",
            "state": "AR",
            "postal_code": "729529008",
            "telephone_number": "479-806-4914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PEDIATRIC PROMISE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-08",
        "last_updated": "2015-06-08",
        "status": "A",
        "authorized_official_last_name": "PRICE",
        "authorized_official_first_name": "KALA",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "INCORPORATOR",
        "authorized_official_telephone_number": "479-806-4914",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.S. CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rudy, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; 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.