Classic Care Pediatrics LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

23947 Issued in AZ

Legal business name

CLASSIC CARE PEDIATRICS LLC

Practice address

7757 W Deer Valley Rd
Suite275
Peoria, AZ 85382-2118

Phone

(623) 262-4926

NPI assigned

Mar 5, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Mark Josephe Gettleman, M.D.

Title

Ceo

Phone

(623) 262-4926

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Karen Prentice, D.O.

  • Pediatrics Physician
  • Peoria, AZ
  • NPI 1760575559
  NPD (past)
• Kristin Sue Shepherd, M.D.

  • Pediatrics Physician
  • Peoria, AZ
  • NPI 1013016500
  NPD (past)

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

{
    "created_epoch": "1362441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362441600000",
    "number": "1689915324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7757 W DEER VALLEY RD",
            "address_2": "SUITE275",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853822118",
            "telephone_number": "623-262-4926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7757 W DEER VALLEY RD",
            "address_2": "SUITE275",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853822118",
            "telephone_number": "623-262-4926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLASSIC CARE PEDIATRICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-05",
        "last_updated": "2013-03-05",
        "status": "A",
        "authorized_official_last_name": "GETTLEMAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "JOSEPHE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "623-262-4926",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "23947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenna Ciolac, PHARM D
• Jacquelinne Cisneros
• City of Peoria (Peoria Fire Medical Department)
• City Wide Transportation
• Keshia Clardy
• Megan Claudio
• Tyler Clayton, LPN
• Clear Choice Hearing Solutions, LLC
• Kimberly Sue Clemens, LPN
• Sherry Cline, RDH

• Pediatrics Physician in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Pediatrics Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2013; 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.