Active NPI
Pediatric Healthcare
- Pediatric Adolescent Medicine Physician
- Sterling Heights, MI
National Provider Identifier
1962446567
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Adolescent Medicine Physician
- Legal business name
- PEDIATRIC HEALTHCARE
- Practice address
- 42141 Mound Rd
Sterling Heights, MI 48314-3144 - Phone
- (586) 254-7593
- Fax
- (586) 254-7834
- NPI assigned
- Jun 15, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ann M Muldoon, CMA
- Title
- Office Manager
- Phone
- (586) 254-7593
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Adolescent Medicine Physician | 2080A0000X | Primary |
Addresses
Primary practice location
42141 Mound Rd
Sterling Heights, MI 48314-3144
Mailing address
42141 Mound Rd
Sterling Heights, MI 48314-3144
Phone (586) 254-7593
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 23D0952600 | Pediatric Healthcare/Sharon MC Manus | Certificate of waiver | Jun 14, 2027 |
National Provider Directory
National Provider DirectoryLocations
42141 Mound Rd
Sterling Heights, MI 48314
Phone (586) 254-7593
42141 Mound Rd
Ste B
Sterling Heights, MI 48314
Phone (586) 254-7593
Practitioners & affiliated clinicians
Practitioners 8
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pediatrics Physician
- Sterling Heights, MI
- NPI 1326543828
-
- Nurse Practitioner
- Royal Oak, MI
- NPI 1811453145
-
- Pediatrics Physician
- Sterling Heights, MI
- NPI 1508848193
-
- Pediatric Nurse Practitioner
- Sterling Heights, MI
- NPI 1447527585
-
- Pediatrics Physician
- Sterling Heights, MI
- NPI 1285668335
-
- Pediatrics Physician
- Sterling Heights, MI
- NPI 1437131448
-
- Pediatrics Physician
- Sterling Heights, MI
- NPI 1023009305
-
- Pediatrics Physician
- El Segundo, CA
- NPI 1184605115
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150329600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1962446567",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "42141 MOUND RD",
"city": "STERLING HEIGHTS",
"state": "MI",
"postal_code": "483143144",
"telephone_number": "586-254-7593",
"fax_number": "586-254-7834"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "42141 MOUND RD",
"city": "STERLING HEIGHTS",
"state": "MI",
"postal_code": "483143144",
"telephone_number": "586-254-7593",
"fax_number": "586-254-7834"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PEDIATRIC HEALTHCARE",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-15",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "MULDOON",
"authorized_official_first_name": "ANN",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "586-254-7593",
"authorized_official_credential": "CMA"
},
"taxonomies": [
{
"code": "2080A0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pediatrics, Adolescent Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Sterling Heights, MI
Sources for this page
- 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 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.