Pediatric Partners PA

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MC2365 Issued in AR

Legal business name

PEDIATRIC PARTNERS PA

Practice address

7303 Rogers Ave
Fort Smith, AR 72903-4112

Phone

(479) 478-7200

Fax

(479) 478-7225

NPI assigned

Mar 21, 2006

Last updated

Aug 22, 2020By 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

Jon R Hendrickson, MDNPI 1447210448

Title

President

Phone

(479) 478-7200

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 6

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.

• Jon R Hendrickson, MD

  • Pediatrics Physician
  • Fort Smith, AR
  • NPI 1447210448
  Medicare reassignment NPD Authorized official
• Kathryn Denise Hendrickson, MD

  • Pediatrics Physician
  • Fort Smith, AR
  • NPI 1093774754
  Medicare reassignment NPD
• Christopher Schluterman, MD

  • Pediatrics Physician
  • Little Rock, AR
  • NPI 1881813111
  Medicare reassignment NPD
• Ashley Gayle Vaughan, NURSE PRACTITIONER

  • Pediatric Nurse Practitioner
  • Fort Smith, AR
  • NPI 1265824841
  Medicare reassignment NPD
• Marylynn Holland, RN, CPNP, APN

  • Pediatric Registered Nurse
  • Fort Smith, AR
  • NPI 1427014901
  NPD (past)
• Kelsey M Loftin, APRN

  • Pediatric Nurse Practitioner
  • Springdale, AR
  • NPI 1578169744
  NPD (past)

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1932168606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11017",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729171017",
            "telephone_number": "479-478-7200",
            "fax_number": "479-478-7225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7303 ROGERS AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729034112",
            "telephone_number": "479-478-7200",
            "fax_number": "479-478-7225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC PARTNERS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HENDRICKSON",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "479-478-7200",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AR",
            "license": "MC2365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "5F086",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maurice Robert Pearl Jr., DC
• Ethan Pearson, MSN, APRN, FNP-C
• Julaine Pearson
• Kristin R Pece, M.D.
• James Michael Peczuh, CRNA
• Pediatric Therapy Connections LLC
• Abby Elizabeth Pekarek
• Liliana Isabel Pelayo
• Deanna R Pelland, RN
• Michelle R Pellerin, P.A.

• Pediatrics Physician in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• Pediatrics Physician in Arkansas

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.