NPIMap

Organization Active NPI

Pediatric Medicine of Wallingford LLP

  • Pediatrics Physician
  • Wallingford, CT
National Provider Identifier
1619004975
Registry record updated Feb 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PEDIATRIC MEDICINE OF WALLINGFORD LLP
Practice address
97 Barnes Road
Suite 6
Wallingford, CT 06492
Phone
(203) 265-9890
Fax
(203) 265-3321
NPI assigned
Feb 27, 2007
Last updated
Feb 12, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2015

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

Authorized official

Name
Steve M Frank, MDNPI 1124137872
Title
Partner
Phone
(203) 265-9890

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
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

97 Barnes Road
Suite 6
Wallingford, CT 06492

Mailing address

97 Barnes Road
Suite 6 Pediatric Medicine of Wallingford LLP
Wallingford, CT 06492
Phone (203) 265-9890

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
07D0685076Pediatric Medicine of Wallingford, LLP97 Barnes Rd, Wallingford, CT 06492Certificate of waiverNov 29, 2027

National Provider Directory

National Provider Directory

Locations

97 Barnes Rd
Ste 6
Wallingford, CT 06492
Phone (203) 265-9890

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423699200000",
    "number": "1619004975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 BARNES ROAD",
            "address_2": "SUITE 6 PEDIATRIC MEDICINE OF WALLINGFORD LLP",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "06492",
            "telephone_number": "203-265-9890",
            "fax_number": "203-265-3321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 BARNES ROAD",
            "address_2": "SUITE 6",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "06492",
            "telephone_number": "203-265-9890",
            "fax_number": "203-265-3321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC MEDICINE OF WALLINGFORD LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2015-02-12",
        "status": "A",
        "authorized_official_last_name": "FRANK",
        "authorized_official_first_name": "STEVE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "203-265-9890",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wallingford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.