Patterson Gastroenterology PLLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

20901 Issued in AZ

Legal business name

PATTERSON GASTROENTEROLOGY PLLC

Doing business as

Patterson Pediatric Gastroenterology PLLC

Practice address

515 W Buckeye Rd
Suite 105
Phoenix, AZ 85003-2647

Phone

(602) 283-3165

Fax

(602) 283-3612

NPI assigned

Dec 9, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Edward Lee Patterson Jr., MEDICAL DOCTOR

Title

Owner/Ceo

Phone

(602) 283-3165

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Patterson Pediatric Gastroenterology PLLC Doing business as

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

{
    "created_epoch": "1323388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323388800000",
    "number": "1912275538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 90482",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850660482",
            "telephone_number": "602-283-3165",
            "fax_number": "602-283-3612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 W BUCKEYE RD",
            "address_2": "SUITE 105",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850032647",
            "telephone_number": "602-283-3165",
            "fax_number": "602-283-3612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATTERSON GASTROENTEROLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-09",
        "last_updated": "2011-12-09",
        "status": "A",
        "authorized_official_last_name": "PATTERSON",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "602-283-3165",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MEDICAL DOCTOR"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "AZ",
            "license": "20901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127820",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Patterson Pediatric Gastroenterology PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mohamed A Pattappurath, PMHNP-BC
• Tina Pattara-Lau, M.D.
• Jamie C Pattee
• Jimmy Ray Patten, DMD
• Lori Marie Patten, R.PH.
• Patterson Schlotterer Medical Group (PS Medical Group)
• Ebony Patterson-Harvey
• Donald Patterson
• Dorothy Patterson
• Edward L Patterson Jr., M.D.

• Clinic/Center in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2011; 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.