NPIMap

Organization Active NPI

Pediatric Center, PC

  • Pediatrics Physician
  • Cedar Rapids, IA
National Provider Identifier
1760487854
Registry record updated Mar 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PEDIATRIC CENTER, PC
Practice address
411 10TH Street SE
Suite 150
Cedar Rapids, IA 52403
Phone
(319) 363-3600
Fax
(319) 363-9971
NPI assigned
Jun 16, 2005
Last updated
Mar 11, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2015

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

Authorized official

Name
Dr. Linda M. McDermottNPI 1841297629
Title
Owner/Shareholder
Phone
(319) 363-3600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X Primary

Addresses

Primary practice location

411 10TH Street SE
Suite 150
Cedar Rapids, IA 52403

Mailing address

411 10TH Street SE
Suite 150
Cedar Rapids, IA 52403
Phone (319) 363-3600

Other identifiers 5

IdentifierTypeStateIssuer
2016428MedicaidIA
0171215MedicaidIA
1053173MedicaidIA
0137885MedicaidIA
1088492MedicaidIA

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: jorieshire@pedicen.allscriptsdirect.net
  • Direct secure messaging: lindamcdermott@pedicen.allscriptsdirect.net
  • Direct secure messaging: mariesvatek@pedicen.allscriptsdirect.net
  • Direct secure messaging: patrickogrady@pedicen.allscriptsdirect.net
  • Direct secure messaging: sarahwickenkamp@pedicen.allscriptsdirect.net
  • Direct secure messaging: susanhalverson@pedicen.allscriptsdirect.net

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426032000000",
    "number": "1760487854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 10TH STREET SE",
            "address_2": "SUITE 150",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "52403",
            "telephone_number": "319-363-3600",
            "fax_number": "319-363-9971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 10TH STREET SE",
            "address_2": "SUITE 150",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "52403",
            "telephone_number": "319-363-3600",
            "fax_number": "319-363-9971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-16",
        "last_updated": "2015-03-11",
        "status": "A",
        "authorized_official_last_name": "MCDERMOTT",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER/SHAREHOLDER",
        "authorized_official_telephone_number": "319-363-3600",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2016428",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0171215",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053173",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0137885",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1088492",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2015; 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.