Infant Jesus Childrens Clinic PLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

INFANT JESUS CHILDRENS CLINIC PLC

Practice address

210 Temple Ave
Colonial Heights, VA 23834-2828

Phone

(804) 520-6137

Fax

(804) 520-7394

NPI assigned

Jul 12, 2006

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

President

Phone

(804) 458-1430

Specialties & licenses 1

Addresses

Other identifiers 5

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 Pediatrics PLC

  • Pediatrics Physician
  • Hopewell, VA
  • NPI 1649483967
  NPD tax ID

Locations

Practitioners 3

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
• Brian Mark Schenberg, MD

  • Pediatrics Physician
  • Colonial Heights, VA
  • NPI 1639115389
  NPD (past)
• Tariq Mohammed Sheikh, MD

  • Pediatrics Physician
  • Chester, VA
  • NPI 1578533857
  NPD (past)

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659306991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 TEMPLE AVE",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238342828",
            "telephone_number": "804-520-6137",
            "fax_number": "804-520-7394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 TEMPLE AVE",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238342828",
            "telephone_number": "804-520-6137",
            "fax_number": "804-520-7394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFANT JESUS CHILDRENS CLINIC PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GONZALES",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "804-458-1430",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARENET",
            "identifier": "17660",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "214596",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SENTARA",
            "identifier": "23468",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "120154",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "214598",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dana Hutcherson, OTR
• Hieu Trong Huynh, D.O.
• Sami Ibrahim
• Chiuzo Ilo, AGPCNP
• John P Impastato, PA-C
• Talha Iqbal, DDS
• Irshad Ahmed MD PC (Colonial Medcare PC)
• Yorckay Chang Ishizawar, M.D.
• Claire Emma Jackson
• Derrell Glenn Jackson, PA-C

• Pediatrics Physician in Colonial Heights, VA
• Providers in Colonial Heights, VA by specialty
• Pediatrics Physician in Virginia

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.