NPIMap

Organization Active NPI

Parkview Pediatrics Inc

  • Health Maintenance Organization
  • Moses Lake, WA
National Provider Identifier
1780809244
Registry record updated Sep 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
Legal business name
PARKVIEW PEDIATRICS INC
Practice address
615 S Division St
Moses Lake, WA 98837-3800
Phone
(509) 766-9450
Fax
(509) 765-9407
NPI assigned
Apr 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2009

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

Authorized official

Name
Dr. Jill A Dudik Bross, MD
Title
President
Phone
(509) 766-9450

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X WA Primary

Addresses

Primary practice location

615 S Division St
Moses Lake, WA 98837-3800

Mailing address

615 S Division St
Moses Lake, WA 98837-3800
Phone (509) 766-9450

Other identifiers 1

IdentifierTypeStateIssuer
7590771MedicaidWA

National Provider Directory

National Provider Directory
Tax ID family
Parkview Pediatrics Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254268800000",
    "number": "1780809244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 S DIVISION ST",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988373800",
            "telephone_number": "509-766-9450",
            "fax_number": "509-765-9407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 S DIVISION ST",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988373800",
            "telephone_number": "509-766-9450",
            "fax_number": "509-765-9407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKVIEW PEDIATRICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2009-09-30",
        "status": "A",
        "authorized_official_last_name": "BROSS",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "A DUDIK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "509-766-9450",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7590771",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moses Lake, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.