Providence Pediatrics

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

PROVIDENCE PEDIATRICS

Practice address

9100 N Central Ave
Suite E
Phoenix, AZ 85020-2430

Phone

(602) 997-9898

Fax

(602) 997-9901

NPI assigned

Mar 19, 2008

Organization subpart

No

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

Authorized official

Name

Lourdes Rodriguez

Title

Billing

Phone

(602) 254-7077

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Providence General Medicine2 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.

• Providence General Medicine

  • Medical Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1508180043
  NPD tax ID

Locations

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

{
    "created_epoch": "1205884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205884800000",
    "number": "1962673772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9100 N CENTRAL AVE",
            "address_2": "SUITE E",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850202430",
            "telephone_number": "602-997-9898",
            "fax_number": "602-997-9901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9100 N CENTRAL AVE",
            "address_2": "SUITE E",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850202430",
            "telephone_number": "602-997-9898",
            "fax_number": "602-997-9901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-19",
        "last_updated": "2008-03-19",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "LOURDES",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "602-254-7077"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "531881",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Providence General Medicine
• Providence General Medicine, PC
• Providence Health Group LLC
• Providence Hospice and Palliative Care Inc
• Providence of Arizona, Inc.
• Providential Western Medical
• Province Anesthesia LLC
• Abby Catherine Prow
• Proxy Medical Group PC
• Roni Benjamin Prucz, MD

• Pediatrics Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Pediatrics Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2008; 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.