NPIMap

Organization Active NPI

Pediatria Healthcare, LLC

  • Pediatric Physical Therapist
  • Wilkes Barre, PA
National Provider Identifier
1619104734
Registry record updated Feb 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
Legal business name
PEDIATRIA HEALTHCARE, LLC
Doing business as
Pediatria HealthCare for Kiks
Practice address
53 Gravel St
Suite C
Wilkes Barre, PA 18705-3738
Phone
(570) 371-5600
Fax
(570) 371-5606
NPI assigned
Jun 16, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2016

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

Authorized official

Name
Susan E. Dignan
Title
General Counsel
Phone
(770) 840-1966

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251P0200X Primary
Pediatric Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XP0200X
Neonatal/Pediatric Certified Respiratory TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2278P3900X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X

Addresses

Primary practice location

53 Gravel St
Suite C
Wilkes Barre, PA 18705-3738

Mailing address

53 Gravel St
Suite C
Wilkes Barre, PA 18705-3738
Phone (570) 371-5600

Other names 1

  • Pediatria HealthCare for Kiks Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1245110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454544000000",
    "number": "1619104734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 GRAVEL ST",
            "address_2": "SUITE C",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187053738",
            "telephone_number": "570-371-5600",
            "fax_number": "570-371-5606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 GRAVEL ST",
            "address_2": "SUITE C",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187053738",
            "telephone_number": "570-371-5600",
            "fax_number": "570-371-5606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIA HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-16",
        "last_updated": "2016-02-04",
        "status": "A",
        "authorized_official_last_name": "DIGNAN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "GENERAL COUNSEL",
        "authorized_official_telephone_number": "770-840-1966"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2278P3900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Respiratory Therapist, Certified, Neonatal/Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatria HealthCare for Kiks",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wilkes Barre, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2016; 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.