Organization Active NPI

JB Healthcare LLC

  • Pediatrics Physician
  • Avondale, AZ
National Provider Identifier
1780146829
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
JB HEALTHCARE LLC
Practice address
10575 W Indian School Rd Ste 103
Avondale, AZ 85392-5651
Phone
(480) 747-0045
Fax
(480) 522-3522
NPI assigned
Apr 5, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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

Authorized official

Name
Ameeta ChowdharyNPI 1710413497
Title
Owner
Phone
(480) 747-0045

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 PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

10575 W Indian School Rd Ste 103
Avondale, AZ 85392-5651

Mailing address

10575 W Indian School Rd Ste 103
Avondale, AZ 85392-5651
Phone (480) 747-0045

Other names 1

  • Little Start Pediatrics Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190729002174 AZ Part B Supplier - Clinic/Group Practice 5092041053 Receives reassigned benefits from 2 practitioners
Practice locations: Avondale, AZ

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
03D2168729JB Healthcare/Little Star Pediatrics10575 W Indian School Rd Suite E-103, Avondale, AZ 85392Certificate of waiverJul 7, 2027

National Provider Directory

National Provider Directory

Locations

10575 W Indian School Rd
Ste E103
Avondale, AZ 85392
Phone (480) 747-0045

10575 W Indian School Rd
#E103
Avondale, AZ 85392

10575 W Indian School Rd
Ste 103
Avondale, AZ 85392
Phone (480) 747-0045

13980 N 67th Ave
Glendale, AZ 85306
Phone (623) 979-9545

Practitioners & affiliated clinicians

Practitioners 2

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": "1554422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660003200000",
    "number": "1780146829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10575 W INDIAN SCHOOL RD STE 103",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853925651",
            "telephone_number": "480-747-0045",
            "fax_number": "480-522-3522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10575 W INDIAN SCHOOL RD STE 103",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853925651",
            "telephone_number": "480-747-0045",
            "fax_number": "480-522-3522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JB HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-05",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A",
        "authorized_official_last_name": "CHOWDHARY",
        "authorized_official_first_name": "AMEETA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-747-0045"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Little Start Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Little Start Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Avondale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.