Emily Elizabeth Pearson

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

30.026749 Issued in OH

Practice address

2200 Olympic St
Springfield, OH 45503-2858

Phone

(937) 390-0493

NPI assigned

Apr 15, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1586908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1609495001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 OLYMPIC ST",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455032858",
            "telephone_number": "937-390-0493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 OLYMPIC ST",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455032858",
            "telephone_number": "937-390-0493"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4401 Penn Ave Fl 3",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152241334",
            "country_code": "US",
            "telephone_number": "412-692-5450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "EMILY",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-15",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OH",
            "license": "30.026749",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Mail",
            "affiliation": "N",
            "endpointDescription": "Use mailing address to communicate",
            "address_1": "2200 Olympic St",
            "city": "Springfield",
            "state": "OH",
            "country_code": "US",
            "postal_code": "455032858",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Thales N Pavlatos, MD
• Crystal Lynn Payne
• Erin Payne
• Jade Payne
• Kristen Payton
• Lisa Pease
• Jared Peck
• Pediatric Associates of Springfield Inc
• Earl Pelfrey
• Fred Pelfrey

• Pediatric Dentistry in Springfield, OH
• Providers in Springfield, OH by specialty
• Pediatric Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.