Pediatric & Adolescent Medicine P.a.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

PEDIATRIC & ADOLESCENT MEDICINE P.A.

Practice address

1803 W 6TH St
Lawrence, KS 66044-1710

Phone

(785) 842-4477

Fax

(785) 842-7433

NPI assigned

Jun 30, 2005

Organization subpart

No

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

Authorized official

Name

Lucas Daniel Houk

Title

Chief Administrative Officer

Phone

(785) 842-4477

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1790782134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1803 W 6TH ST",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660441710",
            "telephone_number": "785-842-4477",
            "fax_number": "785-842-7433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1803 W 6TH ST",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660441710",
            "telephone_number": "785-842-4477",
            "fax_number": "785-842-7433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC & ADOLESCENT MEDICINE P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-30",
        "last_updated": "2022-07-21",
        "certification_date": "2021-02-02",
        "status": "A",
        "authorized_official_last_name": "HOUK",
        "authorized_official_first_name": "LUCAS",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "785-842-4477"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "KS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Lawrence, KS
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.