NPIMap

Organization Active NPI

Pediatrics, Inc

  • Pediatric Nurse Practitioner
  • Glen Allen, VA
National Provider Identifier
1629329610
Registry record updated Oct 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
0024170051 Issued in VA
Legal business name
PEDIATRICS, INC
Practice address
10571 Telegraph Rd
Suite 110
Glen Allen, VA 23059-4652
Phone
(804) 266-9616
Fax
(804) 261-4935
NPI assigned
Oct 1, 2012
Organization subpart
Yes
Parent organization
PEDIATRICS, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 1, 2012

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

Authorized official

Name
Annemarie G Tull, M.D.NPI 1124052147
Title
Vice President
Phone
(805) 545-5050

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
Pediatric Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0200X 0024170051 VA Primary

Addresses

Primary practice location

10571 Telegraph Rd
Suite 110
Glen Allen, VA 23059-4652

Mailing address

10571 Telegraph Rd
Suite 110
Glen Allen, VA 23059-4652
Phone (804) 266-9616

Other names 1

  • Pediatric Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pediatric Center2 organizations share this tax ID, including this one
Part of
Pediatric Center

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 35

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

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1349049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349049600000",
    "number": "1629329610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10571 TELEGRAPH RD",
            "address_2": "SUITE 110",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230594652",
            "telephone_number": "804-266-9616",
            "fax_number": "804-261-4935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10571 TELEGRAPH RD",
            "address_2": "SUITE 110",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230594652",
            "telephone_number": "804-266-9616",
            "fax_number": "804-261-4935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRICS, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PEDIATRICS, INC",
        "enumeration_date": "2012-10-01",
        "last_updated": "2012-10-01",
        "status": "A",
        "authorized_official_last_name": "TULL",
        "authorized_official_first_name": "ANNEMARIE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "805-545-5050",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "VA",
            "license": "0024170051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glen Allen, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2012; 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.