Pediatric and Adolescent Health

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

Legal business name

PEDIATRIC AND ADOLESCENT HEALTH

Practice address

639 Main St
Johnson City, NY 13790-1805

Phone

(607) 770-1988

NPI assigned

May 26, 2006

Organization subpart

No

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

Authorized official

Name

J Roger Chatterton, MD

Title

Physician

Phone

(607) 770-1988

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Channing Carter, M.D.

  • Pediatrics Physician
  • Johnson City, NY
  • NPI 1447414255
  NPD (past)
• Himabindu Kasivajjula, M.D.

  • Pediatrics Physician
  • Johnson City, NY
  • NPI 1558673434
  NPD (past)
• William Miller, M.D.

  • Pediatric Adolescent Medicine Physician
  • Johnson City, NY
  • NPI 1336122563
  NPD (past)
• Runak Patel, M.D.

  • Pediatrics Physician
  • Johnson City, NY
  • NPI 1174942411
  NPD (past)
• Andrea M Shaul, CPNP

  • Pediatric Nurse Practitioner
  • Johnson City, NY
  • NPI 1336632587
  NPD (past)

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619923752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "639 MAIN ST",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137901805",
            "telephone_number": "607-770-1988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "639 MAIN ST",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137901805",
            "telephone_number": "607-770-1988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC AND ADOLESCENT HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHATTERTON",
        "authorized_official_first_name": "J ROGER",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "607-770-1988",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roshni Patel, MD
• Runak Patel, M.D.
• Sagarkumar Patel, NP
• Robert A Patterson, MD
• Gregory Todd Peake, PT
• Theresa Pedroso, PTA
• Abbey C Pelot, LMSW
• Annamalai Periakaruppan, MD
• Madison Shea Perrault, OTR/L
• Camryn Perri

• Pediatric Adolescent Medicine Physician in Johnson City, NY
• Providers in Johnson City, NY by specialty
• Pediatric Adolescent Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.