Jerry Padpad Co, MD

Primary specialty

Addiction Psychiatry PhysicianTaxonomy code 2084P0802X

License

39521 Issued in TN

Practice address

800 Poly PL RM 14-200
Brooklyn, NY 11209

Phone

(718) 836-6600

Fax

(718) 439-4121

NPI assigned

Jul 30, 2006

Last updated

Jul 27, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532649600000",
    "number": "1609881358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 POLY PL RM 14-200",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112097104",
            "telephone_number": "718-836-6600",
            "fax_number": "718-439-4121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 POLY PL RM 14-200",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11209",
            "telephone_number": "718-836-6600",
            "fax_number": "718-439-4121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2841 N Patterson St",
            "address_purpose": "LOCATION",
            "city": "Valdosta",
            "state": "GA",
            "postal_code": "316021743",
            "country_code": "US",
            "telephone_number": "229-316-2618 x1249",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CO",
        "first_name": "JERRY",
        "middle_name": "PADPAD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-30",
        "last_updated": "2018-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "TN",
            "license": "39521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2018; 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.