Chesterfield Pediatrics

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

RIC34 Issued in MO

Legal business name

CHESTERFIELD PEDIATRICS

Practice address

16216 Baxter Road
Suite 310
Chesterfield, MO 63017

Phone

(636) 519-8899

Fax

(636) 519-0011

NPI assigned

May 16, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Darryl S Cohen, D.O.

Title

President

Phone

(636) 519-8899

Specialties & licenses 1

Addresses

Other identifiers 1

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

CLIA laboratory certificates

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224028800000",
    "number": "1629285176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16216 BAXTER ROAD",
            "address_2": "SUITE 310",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "63017",
            "telephone_number": "636-519-8899",
            "fax_number": "636-519-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16216 BAXTER ROAD",
            "address_2": "SUITE 310",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "63017",
            "telephone_number": "636-519-8899",
            "fax_number": "636-519-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESTERFIELD PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2008-10-15",
        "status": "A",
        "authorized_official_last_name": "COHEN",
        "authorized_official_first_name": "DARRYL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "636-519-8899",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "MO",
            "license": "RIC34",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "501104707",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chesterfield Dental Studio, LLC
• Chesterfield Imaging, LLC
• Chesterfield Internal Medicine and Rheumatology, LLC
• Chesterfield Medcenter LLC
• Chesterfield Orthopedics, PC
• Chesterfield Plastic & Reconstructive Surgery LLC
• Chesterfield Plastic Surgery, LLC
• Chesterfield Rehabilitation Physicians, LLC
• Chesterfield Spine & Sports Medicine Center LLC
• Chesterfield Treatment Center

• Pediatric Adolescent Medicine Physician in Chesterfield, MO
• Providers in Chesterfield, MO by specialty
• Pediatric Adolescent Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2008; 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.