University Pediatrics, Inc

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

UNIVERSITY PEDIATRICS, INC

Doing business as

Children's Medical Group

Practice address

100 Highland Ave
Suite 201
Providence, RI 02906-2740

Phone

(401) 633-1100

Fax

(401) 633-0047

NPI assigned

Aug 4, 2006

Last updated

Mar 27, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Robert E Eden, MDNPI 1467495572

Title

Owner

Phone

(401) 633-1100

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Children's Medical Group Doing business as

Locations

Practitioners 3

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.

• Robert Emanuel Eden, M.D.

  • Pediatrics Physician
  • Providence, RI
  • NPI 1467495572
  Authorized official Same address or phone
• Kathryn B Eden, MSW LICSW

  • Clinical Social Worker
  • Providence, RI
  • NPI 1649243981
  NPD (past)
• Angela Susan Rudner, LCSWC

  • Clinical Social Worker
  • Warwick, RI
  • NPI 1831408558
  NPD (past)

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395878400000",
    "number": "1932117702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HIGHLAND AVE",
            "address_2": "SUITE 201",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029062740",
            "telephone_number": "401-633-1100",
            "fax_number": "401-633-0047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HIGHLAND AVE",
            "address_2": "SUITE 201",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029062740",
            "telephone_number": "401-633-1100",
            "fax_number": "401-633-0047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY PEDIATRICS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2014-03-27",
        "status": "A",
        "authorized_official_last_name": "EDEN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "401-633-1100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "RI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "UP29391",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Children's Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• University Orthopedics, Inc.
• University Orthopedics, Inc.
• University Otolaryngology-Head and Neck Surgery, Inc.
• University Pathologists, LLC
• University Pediatrics Dba Children's Medical Group
• University Plastic Surgeons Inc (University Plastic Surgery Associates Inc)
• University Shuttle LLC
• University Surgical Associates, Inc. (Brown Surgical Associates)
• University Urological Associates, Inc.
• University Urological Associates, Inc.

• Pediatrics Physician in Providence, RI
• Providers in Providence, RI by specialty
• Pediatrics Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2014; 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.