Village Pediatrics PLLC

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

Legal business name

VILLAGE PEDIATRICS PLLC

Practice address

31815 Southfield Rd
Suite 14
Beverly Hills, MI 48025-5471

Phone

(248) 644-5626

Fax

(248) 644-5497

NPI assigned

Jul 27, 2011

Last updated

Jul 27, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Herbert J Roth, M.D

Title

President

Phone

(248) 644-5626

Specialties & licenses 1

Addresses

Other identifiers 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Emily Janina Jamett, CPNP-PC

  • Pediatric Nurse Practitioner
  • Beverly Hills, MI
  • NPI 1093351595
  NPD (past)
• Marlene Margaret Roth, M.D.

  • Pediatrics Physician
  • Beverly Hills, MI
  • NPI 1053574954

  Adolescent Medicine

  NPD (past)
• Kalpana S Shah, MD

  • Pediatrics Physician
  • Beverly Hills, MI
  • NPI 1114900487
  NPD (past)

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

{
    "created_epoch": "1311724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311724800000",
    "number": "1962780767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31815 SOUTHFIELD RD",
            "address_2": "SUITE 14",
            "city": "BEVERLY HILLS",
            "state": "MI",
            "postal_code": "480255471",
            "telephone_number": "248-644-5626",
            "fax_number": "248-644-5497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31815 SOUTHFIELD RD",
            "address_2": "SUITE 14",
            "city": "BEVERLY HILLS",
            "state": "MI",
            "postal_code": "480255471",
            "telephone_number": "248-644-5626",
            "fax_number": "248-644-5497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE PEDIATRICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-27",
        "last_updated": "2011-07-27",
        "status": "A",
        "authorized_official_last_name": "ROTH",
        "authorized_official_first_name": "HERBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-644-5626",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053574954",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1568452761",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas Psychological
• Quinn Vincent Thomas, MA, LLP
• James Michael Vandaele, PA-C
• Heather Elyse Vieder, M.S. CCC-SLP
• Jocelyn Kimberly Vieira, RN, AG-ACNP-BC
• Village Pharmacy Compounding 3 Inc
• Joseph M Vitale, DPT
• Sylvia Leah Voelker, PH.D.
• Karen Alyse Waldrop, LPC
• Carla Renee Washington-Faye, LPC, ATR

• Pediatric Adolescent Medicine Physician in Beverly Hills, MI
• Providers in Beverly Hills, MI by specialty
• Pediatric Adolescent Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2011; 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.

Verify at the official NPI Registry.