Pedi-Care, Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

340159 Issued in MN

Legal business name

PEDI-CARE, INC

Practice address

17048 Patricia St
Paynesville, MN 56362-9725

Phone

(612) 356-0207

Fax

(320) 453-3579

NPI assigned

Jun 19, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Jennifer J Ryan, RN

Title

President

Phone

(612) 356-0207

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1213833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455840000000",
    "number": "1659532950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17048 PATRICIA ST",
            "city": "PAYNESVILLE",
            "state": "MN",
            "postal_code": "563629725",
            "telephone_number": "612-345-0207",
            "fax_number": "320-453-3579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17048 PATRICIA ST",
            "city": "PAYNESVILLE",
            "state": "MN",
            "postal_code": "563629725",
            "telephone_number": "612-356-0207",
            "fax_number": "320-453-3579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDI-CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-19",
        "last_updated": "2016-02-19",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "612-356-0207",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MN",
            "license": "340159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Paynesville, MN
• Providers in Paynesville, MN by specialty
• Home Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2016; 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.