NPIMap

Organization Active NPI

Pediatric Products, LLC

  • Durable Medical Equipment & Medical Supplies
  • Shelbyville, KY
National Provider Identifier
1972625622
Registry record updated May 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
PEDIATRIC PRODUCTS, LLC
Practice address
533 Main St
Suite 1
Shelbyville, KY 40065-1119
Phone
(888) 721-6893
Fax
(513) 891-4654
NPI assigned
Apr 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2009

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

Authorized official

Name
Randy Paulson
Title
Ceo
Phone
(513) 891-4633

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

533 Main St
Suite 1
Shelbyville, KY 40065-1119

Mailing address

10679 McSwain Drive
Cincinnati, OH 45241-3168
Phone (513) 891-4633

Other identifiers 1

IdentifierTypeStateIssuer
90012857MedicaidKY

Other names 1

  • Xpress Nebs Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pediatric Products LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

533 Main St
#1
Shelbyville, KY 40065
Phone (888) 721-6893

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242864000000",
    "number": "1972625622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10679 MCSWAIN DRIVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452413168",
            "telephone_number": "513-891-4633",
            "fax_number": "513-891-4654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "533 MAIN ST",
            "address_2": "SUITE 1",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400651119",
            "telephone_number": "888-721-6893",
            "fax_number": "513-891-4654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC PRODUCTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2009-05-21",
        "status": "A",
        "authorized_official_last_name": "PAULSON",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "513-891-4633"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90012857",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Xpress Nebs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shelbyville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2009; 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.