The Pediatric Healthcare Center LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

35068454 Issued in OH

Legal business name

THE PEDIATRIC HEALTHCARE CENTER LLC

Practice address

1010 Hager St
St Marys, OH 45885

Phone

(419) 394-2610

Fax

(419) 394-6605

NPI assigned

Mar 28, 2006

Last updated

Mar 28, 2012By 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

Cheryl Kuck, MD

Title

Physician/Owner

Phone

(419) 394-2610

Specialties & licenses 1

Addresses

Other names 1

• The Pediatric Healthcare Center Other name

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332892800000",
    "number": "1609837038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 HAGER ST",
            "city": "SAINT MARYS",
            "state": "OH",
            "postal_code": "458852421",
            "telephone_number": "419-394-2610",
            "fax_number": "419-394-6605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 HAGER ST",
            "city": "ST MARYS",
            "state": "OH",
            "postal_code": "45885",
            "telephone_number": "419-394-2610",
            "fax_number": "419-394-6605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PEDIATRIC HEALTHCARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-28",
        "last_updated": "2012-03-28",
        "status": "A",
        "authorized_official_last_name": "KUCK",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "419-394-2610",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35068454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Pediatric Healthcare Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Justina Lynn Staroska, CNM
• Christopher John Stucke, DPM
• Laura Susan Studer
• Marcia S Sutton
• Jonathan Reyes Tagle, DC
• Juan Torres-Cordero, MD
• Polly Fleet Train, MD
• True Blue Hospice, LLC.
• True-Blue Transport LLC.
• Macy L Turner

• Pediatrics Physician in Saint Marys, OH
• Providers in Saint Marys, OH by specialty
• Pediatrics Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2012; 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.