Pediatric Care Inc

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

PEDIATRIC CARE INC

Practice address

1675 N. Freedom Blvd.
#3
Provo, UT 84604

Phone

(801) 377-8000

Fax

(801) 377-8001

NPI assigned

Mar 22, 2006

Organization subpart

No

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

Authorized official

Name

Bret Woods

Title

Administrator

Phone

(801) 400-2050

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jane Craigo, NP

  • Family Nurse Practitioner
  • Heber City, UT
  • NPI 1558960849
  NPD (past)
• Joshua Darrell Fuller, M.D.

  • Pediatrics Physician
  • Provo, UT
  • NPI 1063723708

  Pediatrics

  NPD (past)
• Canessa Craigo Leeflang, FNP

  • Pediatric Nurse Practitioner
  • Provo, UT
  • NPI 1518243187
  NPD (past)
• Aubrey Leavitt Wright, DNP, APRN, FNP-C

  • Family Nurse Practitioner
  • Orem, UT
  • NPI 1992501365
  NPD (past)
• Kenneth A Zollo, MD

  • Pediatrics Physician
  • Provo, UT
  • NPI 1770545931

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320883200000",
    "number": "1811956352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1001",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846031001",
            "telephone_number": "801-377-8000",
            "fax_number": "801-377-8001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 N. FREEDOM BLVD.",
            "address_2": "#3",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "84604",
            "telephone_number": "801-377-8000",
            "fax_number": "801-377-8001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-22",
        "last_updated": "2011-11-10",
        "status": "A",
        "authorized_official_last_name": "WOODS",
        "authorized_official_first_name": "BRET",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "801-400-2050"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ben B Peay, RN
• Christopher Elson Peck, PH.D.
• Hannah Peck
• Amber Lyn Pedersen
• Tyler R. Pedersen, PH.D.
• Janelle Pedroza
• Gregory Smith Peirce, M.D.
• Emma Laura Pelaez
• Katerina Corral Pena-Kennan
• Diego Pena IV

• All providers in Provo, UT
• Pediatrics Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.