NPIMap

Organization Active NPI

Pediatria

  • Clinic/Center
  • Phoenix, AZ
National Provider Identifier
1801064753
Registry record updated Feb 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
17010 Issued in AZ
Legal business name
PEDIATRIA
Doing business as
Dr B's Childrens Office
Practice address
4524 N Maryvale Pkwy
Suite 110
Phoenix, AZ 85031-1730
Phone
(623) 845-9009
Fax
(623) 845-6933
NPI assigned
Feb 13, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2008

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

Authorized official

Name
Dr. Jaime Balderrama, M.D.NPI 1457344715
Title
Ceo
Phone
(623) 845-9009

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
Clinic/Center 261Q00000X 17010 AZ Primary

Addresses

Primary practice location

4524 N Maryvale Pkwy
Suite 110
Phoenix, AZ 85031-1730

Mailing address

4524 N Maryvale Pkwy
Suite 110
Phoenix, AZ 85031-1730
Phone (623) 845-9009

Other names 1

  • Dr B's Childrens Office Doing business as

National Provider Directory

National Provider Directory

Locations

4524 N Maryvale Pkwy
Ste 110
Phoenix, AZ 85031
Phone (623) 845-9009

Practitioners & affiliated clinicians

Practitioners 3

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": "1202860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202860800000",
    "number": "1801064753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4524 N MARYVALE PKWY",
            "address_2": "SUITE 110",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850311730",
            "telephone_number": "623-845-9009",
            "fax_number": "623-845-6933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4524 N MARYVALE PKWY",
            "address_2": "SUITE 110",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850311730",
            "telephone_number": "623-845-9009",
            "fax_number": "623-845-6933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-13",
        "last_updated": "2008-02-13",
        "status": "A",
        "authorized_official_last_name": "BALDERRAMA",
        "authorized_official_first_name": "JAIME",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "623-845-9009",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "AZ",
            "license": "17010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr B's Childrens Office",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2008; 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.