NPIMap

Organization Active NPI

Pediatric Partners of Virginia, LLC

Doing business as Pediatric Partnership

  • Pediatrics Physician
  • Glen Allen, VA
National Provider Identifier
1942630397
Registry record updated Nov 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0101051967 Issued in VA
Legal business name
PEDIATRIC PARTNERS OF VIRGINIA, LLC
Doing business as
Pediatric Partnership
Practice address
5207 Hickory Park Dr Ste C
Glen Allen, VA 23059-2624
Phone
(804) 377-8981
Fax
(804) 377-8984
NPI assigned
Nov 22, 2013
Last updated
Nov 23, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
PEDIATRIC PARTNERS OF VIRGINIA, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 23, 2022

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

Authorized official

Name
David Sutherland
Title
Administrator
Phone
(804) 363-0270

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 0101051967 VA Primary

Addresses

Primary practice location

5207 Hickory Park Dr Ste C
Glen Allen, VA 23059-2624

Mailing address

5207 Hickory Park Dr Ste C
Glen Allen, VA 23059-2624
Phone (804) 377-8981

Other names 1

  • Pediatric Partnership Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pediatric Associates6 organizations share this tax ID, including this one
Part of
Pediatric Associates

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1385078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669161600000",
    "number": "1942630397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5207 HICKORY PARK DR STE C",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230592624",
            "telephone_number": "804-377-8981",
            "fax_number": "804-377-8984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5207 HICKORY PARK DR STE C",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230592624",
            "telephone_number": "804-377-8981",
            "fax_number": "804-377-8984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC PARTNERS OF VIRGINIA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PEDIATRIC PARTNERS OF VIRGINIA, LLC",
        "enumeration_date": "2013-11-22",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A",
        "authorized_official_last_name": "SUTHERLAND",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "804-363-0270"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101051967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Partnership",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glen Allen, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2022; 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.