NPIMap

Organization Active NPI

Kinston Pediatric Associates PA

  • Pediatrics Physician
  • Kinston, NC
National Provider Identifier
1871577197
Registry record updated Feb 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
KINSTON PEDIATRIC ASSOCIATES PA
Practice address
2509 North Queen St
Kinston, NC 28502
Phone
(252) 522-0335
Fax
(252) 522-4016
NPI assigned
Nov 30, 2005
Last updated
Feb 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2024

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

Authorized official

Name
Dr. Donald M Riddle, MDNPI 1861476061
Title
MD/President
Phone
(252) 522-0335

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 Physician 208000000X NU Primary

Addresses

Primary practice location

2509 North Queen St
Kinston, NC 28502

Mailing address

PO Box 1419
Kinston, NC 28503
Phone (252) 522-0335

Other identifiers 2

IdentifierTypeStateIssuer
8901980MedicaidNC
O1980OtherBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

110 E Park Dr
Beulaville, NC 28518
Phone (910) 298-6550

416 McCrae St
Grifton, NC 28530
Phone (252) 524-4463

2509 N Queen St
Kinston, NC 28501
Phone (252) 522-0335

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708560000000",
    "number": "1871577197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1419",
            "city": "KINSTON",
            "state": "NC",
            "postal_code": "28503",
            "telephone_number": "252-522-0335",
            "fax_number": "252-522-4016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2509 NORTH QUEEN ST",
            "city": "KINSTON",
            "state": "NC",
            "postal_code": "28502",
            "telephone_number": "252-522-0335",
            "fax_number": "252-522-4016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINSTON PEDIATRIC ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-30",
        "last_updated": "2024-02-22",
        "status": "A",
        "authorized_official_last_name": "RIDDLE",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MD/PRESIDENT",
        "authorized_official_telephone_number": "252-522-0335",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8901980",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "O1980",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kinston, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.