NPIMap

Organization Active NPI

Pediatric Development Center

  • Voluntary or Charitable Agency
  • Pittsfield, MA
National Provider Identifier
1962579151
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Voluntary or Charitable AgencyTaxonomy code 251V00000X
License
356074 Issued in MA
Legal business name
PEDIATRIC DEVELOPMENT CENTER
Practice address
388 Columbus Ave
Pittsfield, MA 01201-4903
Phone
(413) 499-4537
Fax
(413) 448-8223
NPI assigned
Nov 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Maureen Atwood
Title
Executive Director
Phone
(413) 499-4537

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Voluntary or Charitable Agency 251V00000X 356074 MA Primary

Addresses

Primary practice location

388 Columbus Ave
Pittsfield, MA 01201-4903

Mailing address

388 Columbus Ave
Pittsfield, MA 01201-4903
Phone (413) 499-4537

Other identifiers 1

IdentifierTypeStateIssuer
1800701MedicaidMA

National Provider Directory

National Provider Directory
Tax ID family
PDC South2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

388 Columbus Ave
Pittsfield, MA 01201
Phone (413) 499-4537

Practitioners & affiliated clinicians

Practitioners 45

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

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962579151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "388 COLUMBUS AVE",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012014903",
            "telephone_number": "413-499-4537",
            "fax_number": "413-448-8223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "388 COLUMBUS AVE",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012014903",
            "telephone_number": "413-499-4537",
            "fax_number": "413-448-8223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DEVELOPMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ATWOOD",
        "authorized_official_first_name": "MAUREEN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "413-499-4537",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": "MA",
            "license": "356074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1800701",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsfield, MA

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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.