Organization Active NPI

Gainesville Pediatric Associates Inc

  • Pediatrics Physician
  • Gainesville, FL
National Provider Identifier
1710050596
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
GAINESVILLE PEDIATRIC ASSOCIATES INC
Practice address
6440 W Newberry Road
Suite 402
Gainesville, FL 32605
Phone
(352) 333-5500
Fax
(352) 333-5506
NPI assigned
Nov 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Michael W Wyatt, MD
Title
President
Phone
(352) 333-5500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

6440 W Newberry Road
Suite 402
Gainesville, FL 32605

Mailing address

6440 W Newberry Road
Suite 402
Gainesville, FL 32605
Phone (352) 333-5500

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0271787Gainesville Pediatric Associates6440 W Newberry Rd Ste 402, Gainesville, FL 32605ComplianceApr 4, 2027

National Provider Directory

National Provider Directory

Locations

6440 W Newberry Rd
Ste 402
Gainesville, FL 32605
Phone (352) 332-5500

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710050596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6440 W NEWBERRY ROAD",
            "address_2": "SUITE 402",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "32605",
            "telephone_number": "352-333-5500",
            "fax_number": "352-333-5506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6440 W NEWBERRY ROAD",
            "address_2": "SUITE 402",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "32605",
            "telephone_number": "352-333-5500",
            "fax_number": "352-333-5506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAINESVILLE PEDIATRIC ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WYATT",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-333-5500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • 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.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.