NPIMap

Organization Active NPI

Mercer Pediatrics PSC

Doing business as Haggin Primary Care Clinic

  • Pediatrics Physician
  • Harrodsburg, KY
National Provider Identifier
1669415493
Registry record updated Mar 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25108 Issued in KY
Legal business name
MERCER PEDIATRICS PSC
Doing business as
Haggin Primary Care Clinic
Practice address
466 Linden Ave
Harrodsburg, KY 40330-1841
Phone
(859) 734-5123
Fax
(859) 734-0664
NPI assigned
Jun 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2014

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

Authorized official

Name
Dr. Pamela G Johnson, MD
Title
President/Ceo
Phone
(859) 734-5123

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 25108 KY Primary

Addresses

Primary practice location

466 Linden Ave
Harrodsburg, KY 40330-1841

Mailing address

PO Box 364
466 Linden Avenue
Harrodsburg, KY 40330-0364
Phone (859) 734-5123

Other identifiers 2

IdentifierTypeStateIssuer
65929507MedicaidKY
610510934MedicaidKY

Other names 1

  • Haggin Primary Care Clinic Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394150400000",
    "number": "1669415493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 364",
            "address_2": "466 LINDEN AVENUE",
            "city": "HARRODSBURG",
            "state": "KY",
            "postal_code": "403300364",
            "telephone_number": "859-734-5123",
            "fax_number": "859-734-0664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "466 LINDEN AVE",
            "city": "HARRODSBURG",
            "state": "KY",
            "postal_code": "403301841",
            "telephone_number": "859-734-5123",
            "fax_number": "859-734-0664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCER PEDIATRICS PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-13",
        "last_updated": "2014-03-07",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "859-734-5123",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "25108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65929507",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "610510934",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Haggin Primary Care Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Harrodsburg, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2014; 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.