Fayette County Pediatrics LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

FAYETTE COUNTY PEDIATRICS LLC

Practice address

2025 Virginia Ave
Connersville, IN 47331-2921

Phone

(765) 825-4949

NPI assigned

Jan 20, 2006

Last updated

Aug 22, 2020By 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

John Tan, MDNPI 1093795395

Title

Owner

Phone

(765) 825-4949

Specialties & licenses 1

Addresses

Practitioners 1

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.

• John U. Tan, MD

  • Pediatrics Physician
  • Connersville, IN
  • NPI 1093795395
  NPD (past) Authorized official

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972583227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 779",
            "city": "CONNERSVILLE",
            "state": "IN",
            "postal_code": "473310779",
            "telephone_number": "765-827-1903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 VIRGINIA AVE",
            "city": "CONNERSVILLE",
            "state": "IN",
            "postal_code": "473312921",
            "telephone_number": "765-825-4949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAYETTE COUNTY PEDIATRICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "765-825-4949",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caitlin Fattore
• Fayette BHC LLC
• Fayette BHC LLC
• Fayette Co Physician Organization Dba Family Practice WVMC
• Fayette County Government
• Fayette County Physician Orginazation LLC (Whitewater Valley Urgent Care)
• Fayette County School Corp
• Fayette Family Practice, Inc.
• Fayette Memorial Hospital Assoc (FMH Ambulance)
• Fayette Memorial Hospital Assoc Inc (Connersville Immediate Care)

• Pediatrics Physician in Connersville, IN
• Providers in Connersville, IN by specialty
• Pediatrics Physician in Indiana

• 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.