Pediatric Behavior Management Professionals

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PEDIATRIC BEHAVIOR MANAGEMENT PROFESSIONALS

Practice address

3651 Lindell Rd
Ste D
Las Vegas, NV 89103-1254

Phone

(702) 473-8222

NPI assigned

Nov 7, 2013

Organization subpart

No

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

Authorized official

Name

Jervon Slack

Title

Owner

Phone

(702) 473-8222

Specialties & licenses 1

Addresses

Other names 1

• PBMP Other name

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

{
    "created_epoch": "1383782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384300800000",
    "number": "1871922054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3651 LINDELL RD",
            "address_2": "STE D",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891031254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3651 LINDELL RD",
            "address_2": "STE D",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891031254",
            "telephone_number": "702-473-8222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC BEHAVIOR MANAGEMENT PROFESSIONALS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-07",
        "last_updated": "2013-11-13",
        "status": "A",
        "authorized_official_last_name": "SLACK",
        "authorized_official_first_name": "JERVON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-473-8222"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PBMP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kendal L Pedersen
• Robert Pedersen
• Stephen Pedersen, HIGH SCHOOL DIPLOMA
• Anita G Pederson
• Christopher A Pederson, M.D., M.P.H.
• Pediatric Collective LLC
• Pediatric Gastroenterology Prof Assn
• Pediatric Sub-Specialists of Nevada, LLC
• Pediatric Surgery Associates
• Michael Ronald Pedler, R.N,

• Community/Behavioral Health Agency in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Community/Behavioral Health Agency in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2013; 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.