NPIMap

Organization Active NPI

Upper Valley Professional Corporation

Doing business as Pediatric Group

  • Pediatrics Physician
  • Piqua, OH
National Provider Identifier
1740389766
Registry record updated Aug 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
UPPER VALLEY PROFESSIONAL CORPORATION
Doing business as
Pediatric Group
Practice address
280 Looney Rd
Suite 101
Piqua, OH 45356-4199
Phone
(937) 440-8687
Fax
(937) 773-8058
NPI assigned
Sep 22, 2006
Last updated
Aug 20, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2010

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

Authorized official

Name
Pamela Rader
Title
Administrator
Phone
(937) 440-7454

Specialties & licenses 1

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

Addresses

Primary practice location

280 Looney Rd
Suite 101
Piqua, OH 45356-4199

Mailing address

PO Box 479
Troy, OH 45373-0479
Phone (937) 440-8687

Other identifiers 1

IdentifierTypeStateIssuer
2616404MedicaidOH

Other names 1

  • Pediatric Group Doing business as

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
36D0976737Uvpc-the Pediatric Group280 Looney Road, Piqua, OH 45356Certificate of waiverMar 22, 2028

National Provider Directory

National Provider Directory
Tax ID family
Upper Valley Profession9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

280 Looney Rd
Ste 101
Piqua, OH 45356
Phone (937) 440-8687

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282262400000",
    "number": "1740389766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 479",
            "city": "TROY",
            "state": "OH",
            "postal_code": "453730479",
            "telephone_number": "937-440-8687",
            "fax_number": "937-773-8058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 LOONEY RD",
            "address_2": "SUITE 101",
            "city": "PIQUA",
            "state": "OH",
            "postal_code": "453564199",
            "telephone_number": "937-440-8687",
            "fax_number": "937-773-8058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPPER VALLEY PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2010-08-20",
        "status": "A",
        "authorized_official_last_name": "RADER",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "937-440-7454"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2616404",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Piqua, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2010; 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.