NPIMap

Organization Active NPI

Plymouth Pediatric Associates, LLC

Doing business as Plymouth Pediatric Associates

  • Pediatrics Physician
  • Plymouth, MA
National Provider Identifier
1851773584
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PLYMOUTH PEDIATRIC ASSOCIATES, LLC
Doing business as
Plymouth Pediatric Associates
Practice address
148 Industrial Park Rd
Plymouth, MA 02360-7243
Phone
(508) 747-5900
Fax
(508) 747-2290
NPI assigned
Jun 18, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Authorized official

Name
Dr. Jessica Walsh, D.O.NPI 1861601189
Title
Managing Member
Phone
(508) 747-5900

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: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

148 Industrial Park Rd
Plymouth, MA 02360-7243

Mailing address

148 Industrial Park Rd
Plymouth, MA 02360-7243
Phone (508) 747-5900

Other names 1

  • Plymouth Pediatric Associates Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Plymouth Pediatric Associates2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

148 Industrial Park Rd
Plymouth, MA 02360
Phone (508) 503-2646

441 Route 130
Ste 11
Sandwich, MA 02563

99 Commerce Way
Woburn, MA 01801
Phone (516) 207-7936

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1434585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721001600000",
    "number": "1851773584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 INDUSTRIAL PARK RD",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023607243",
            "telephone_number": "508-747-5900",
            "fax_number": "508-747-2290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 INDUSTRIAL PARK RD",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023607243",
            "telephone_number": "508-747-5900",
            "fax_number": "508-747-2290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLYMOUTH PEDIATRIC ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-18",
        "last_updated": "2024-07-15",
        "certification_date": "2023-09-21",
        "status": "A",
        "authorized_official_last_name": "WALSH",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "508-747-5900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Plymouth Pediatric Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Plymouth Pediatric Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Plymouth, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; 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.