Pediatric Specialists of Montgomery, L.L.C.

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

License

16678 Issued in AL

Legal business name

PEDIATRIC SPECIALISTS OF MONTGOMERY, L.L.C.

Practice address

239 Mitylene Park Dr
Montgomery, AL 36117-3547

Phone

(334) 612-2111

Fax

(334) 612-2166

NPI assigned

Jan 30, 2006

Organization subpart

No

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

Authorized official

Name

Meredith Daffin

Title

Administrator

Phone

(334) 612-2111

Specialties & licenses 1

Addresses

Practitioners 2

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

• Barton B Cook, MD

  • Pediatric Cardiology Physician
  • Montgomery, AL
  • NPI 1285605055
  NPD (past)
• Gerardo Sixto Gonzalez, MD

  • Pediatric Cardiology Physician
  • Montgomery, AL
  • NPI 1245206804
  NPD (past)

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891766762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 MITYLENE PARK DR",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361173547",
            "telephone_number": "334-612-2111",
            "fax_number": "334-612-2166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 MITYLENE PARK DR",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361173547",
            "telephone_number": "334-612-2111",
            "fax_number": "334-612-2166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC SPECIALISTS OF MONTGOMERY, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DAFFIN",
        "authorized_official_first_name": "MEREDITH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "334-612-2111"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "AL",
            "license": "16678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rufus Shanks Pearson Jr., CRNA
• Samuel Lavone Peavy, D.C.
• Stephanie Peavy
• Krista Pedersen, PHARM.D.
• Pediatric Healthcare, LLC
• Pediatric Therapy Services LLC
• Pediatrics After Hours Care LLC
• Pediatrics at Twilight,LLC
• Emily Pell, MA CCC-SLP
• Ann Pemberton

• Pediatric Cardiology Physician in Montgomery, AL
• Providers in Montgomery, AL by specialty
• Pediatric Cardiology Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.