Infant Jesus Pediatrics PLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0101026123 Issued in VA

Legal business name

INFANT JESUS PEDIATRICS PLC

Practice address

505 North 6TH Ave
Hopewell, VA 23860-2618

Phone

(804) 458-1430

Fax

(804) 458-8857

NPI assigned

May 7, 2007

Organization subpart

No

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

Authorized official

Name

Patricia D Gonzales, MDNPI 1891720074

Title

Medical Director

Phone

(804) 458-1430

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

Infant Jesus Childrens Clinic PLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Infant Jesus Childrens Clinic PLC

  • Pediatrics Physician
  • Colonial Heights, VA
  • NPI 1659306991
  NPD tax ID

Locations

Practitioners 1

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

• Patricia D Gonzales, MD

  • Pediatrics Physician
  • Hopewell, VA
  • NPI 1891720074
  NPD Authorized official

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617235200000",
    "number": "1649483967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 N 6TH AVE",
            "city": "HOPEWELL",
            "state": "VA",
            "postal_code": "238602618",
            "telephone_number": "804-458-1430",
            "fax_number": "804-458-8857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 NORTH 6TH AVE",
            "city": "HOPEWELL",
            "state": "VA",
            "postal_code": "238602618",
            "telephone_number": "804-458-1430",
            "fax_number": "804-458-8857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFANT JESUS PEDIATRICS PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A",
        "authorized_official_last_name": "GONZALES",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "804-458-1430",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101026123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR PATRICIA GONZALES NPI",
            "identifier": "1891720074",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR HERMES DIZON NPI",
            "identifier": "1538131625",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Hopewell, VA
• Providers in Hopewell, VA by specialty
• Pediatrics Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2021; 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.