Pediatric Associates of Decatur LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD29718 Issued in AL

Legal business name

PEDIATRIC ASSOCIATES OF DECATUR LLC

Practice address

1874 Beltline Rd SW
Suite 160
Decatur, AL 35601-5514

Phone

(256) 306-9400

Fax

(256) 306-9896

NPI assigned

Aug 25, 2009

Organization subpart

No

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

Authorized official

Name

Sushil S Valavalkar, MD

Title

Physician/Owner

Phone

(256) 306-9400

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1251158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251158400000",
    "number": "1699908673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1874 BELTLINE RD SW",
            "address_2": "SUITE 160",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356015514",
            "telephone_number": "256-306-9400",
            "fax_number": "256-306-9896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1874 BELTLINE RD SW",
            "address_2": "SUITE 160",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356015514",
            "telephone_number": "256-306-9400",
            "fax_number": "256-306-9896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ASSOCIATES OF DECATUR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-25",
        "last_updated": "2009-08-25",
        "status": "A",
        "authorized_official_last_name": "VALAVALKAR",
        "authorized_official_first_name": "SUSHIL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "256-306-9400",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "AL",
            "license": "MD29718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Decatur, AL
• Providers in Decatur, AL by specialty
• Pediatrics Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2009; 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.