Pediatric ENT Associates

Primary specialty

Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X

Legal business name

PEDIATRIC ENT ASSOCIATES

Practice address

910 E 26TH St
Suite 323
Minneapolis, MN 55404-4526

Phone

(612) 874-1292

NPI assigned

Oct 25, 2006

Organization subpart

No

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

Authorized official

Name

Barbara A Heimerl

Title

Manager

Phone

(612) 874-1292

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669556668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 E 26TH ST",
            "address_2": "SUITE 323",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044526",
            "telephone_number": "612-874-1292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 E 26TH ST",
            "address_2": "SUITE 323",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044526",
            "telephone_number": "612-874-1292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ENT ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HEIMERL",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "612-874-1292"
    },
    "taxonomies": [
        {
            "code": "207YP0228X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathy Pederson, MSW, LICSW
• Kristina L Pederson
• Paris Pederson, LADC
• Suzanne K Pederson, M.S., L.P.
• Valerie Pederson, MS, LPCC
• Pediatric Radiology, P.a.
• Pediatric Surgical Associates LTD
• Pediatric Urology Associates, P.a.
• Peek Pca
• Syed Murfad Peer, M.D

• Pediatric Otolaryngology Physician in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Pediatric Otolaryngology Physician in Minnesota

• 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.