Pediatric Center Holdings, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

PEDIATRIC CENTER HOLDINGS, LLC

Practice address

15450 Highway 7 Ste 200
Minnetonka, MN 55345-3522

Phone

(763) 581-8960

NPI assigned

Mar 5, 2018

Organization subpart

No

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

Authorized official

Name

Mrs. Traci Marie Albers

Title

Director of Operations

Phone

(612) 718-0092

Specialties & licenses 1

Addresses

Other names 1

• Hummingbird Ear Tube Clinic for Kids Doing business as

Tax ID family

Hummingbird Ear Tube Clinic for Kids2 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.

• Pediatric Center Holdings, LLC

  • Ambulatory Surgical Clinic/Center
  • Minnetonka, MN
  • NPI 1952898405
  NPD tax ID

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

{
    "created_epoch": "1520208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520208000000",
    "number": "1891297925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1158 SUNRISE ALCOVE",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551259284",
            "telephone_number": "612-718-0092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15450 HIGHWAY 7 STE 200",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553453522",
            "telephone_number": "763-581-8960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC CENTER HOLDINGS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-05",
        "last_updated": "2018-03-05",
        "status": "A",
        "authorized_official_last_name": "ALBERS",
        "authorized_official_first_name": "TRACI",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "612-718-0092",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hummingbird Ear Tube Clinic for Kids",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kaylee Marie Pearson, LGSW
• Mary Jane Pearson, MSW, LICSW
• Benjamin Pease III
• Stephanie P Pedersen, L.P.
• Pediatech Nursing LLC
• Pediatric Center Holdings, LLC
• Peggy Maki PHD LLC
• Hannah Pelegano, MSW, LGSW
• Stephanie Lee Peng, M.D.
• Denise Pennicooke, NP

• Ambulatory Surgical Clinic/Center in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Ambulatory Surgical Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2018; 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.