NPIMap

Organization Active NPI

Highland Pediatrics & Adolescent Medicine

  • Pediatrics Physician
  • Highland, IL
National Provider Identifier
1942321773
Registry record updated Oct 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
HIGHLAND PEDIATRICS & ADOLESCENT MEDICINE
Practice address
1250 Mercantile Dr
Highland, IL 62249-1239
Phone
(618) 654-4449
Fax
(618) 654-3974
NPI assigned
Apr 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2011

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

Authorized official

Name
Dr. Debra Feldott-JohnsonNPI 1184616286
Title
President
Phone
(618) 654-4449

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

1250 Mercantile Dr
Highland, IL 62249-1239

Mailing address

1250 Mercantile Dr
Highland, IL 62249-1239
Phone (618) 654-4449

National Provider Directory

National Provider Directory

Locations

1250 Mercantile Dr
Highland, IL 62249
Phone (618) 654-4449

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318464000000",
    "number": "1942321773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 MERCANTILE DR",
            "city": "HIGHLAND",
            "state": "IL",
            "postal_code": "622491239",
            "telephone_number": "618-654-4449",
            "fax_number": "618-654-3974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 MERCANTILE DR",
            "city": "HIGHLAND",
            "state": "IL",
            "postal_code": "622491239",
            "telephone_number": "618-654-4449",
            "fax_number": "618-654-3974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHLAND PEDIATRICS & ADOLESCENT MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2011-10-13",
        "status": "A",
        "authorized_official_last_name": "FELDOTT-JOHNSON",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-654-4449",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.