NPIMap

Organization Active NPI

Colonial Heights Pediatrics LTD.

  • Pediatrics Physician
  • Colonial Heights, VA
National Provider Identifier
1972797256
Registry record updated Aug 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
COLONIAL HEIGHTS PEDIATRICS LTD.
Practice address
16011 Kairos Rd
Suite 'a'
Colonial Heights, VA 23834-5205
Phone
(804) 520-2600
Fax
(604) 520-5853
NPI assigned
Aug 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2007

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

Authorized official

Name
Jawed Iqbal, M.D.,NPI 1205893930
Title
Director
Phone
(804) 520-2600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X VA Primary

Addresses

Primary practice location

16011 Kairos Rd
Suite 'a'
Colonial Heights, VA 23834-5205

Mailing address

16011 Kairos Rd
Suite 'a'
Colonial Heights, VA 23834-5205
Phone (804) 520-2600

Other identifiers 2

IdentifierTypeStateIssuer
G62833MedicaidVA
G61226MedicaidVA

Other names 1

  • Petersburg Children Clinic Former legal business name

National Provider Directory

National Provider Directory

Locations

83 Sherwood Dr
Colonial Heights, VA 23834

16011 Kairos Rd
Ste A
South Chesterfield, VA 23834
Phone (804) 520-2600

16011 Kairos Rd
Ste 100
South Chesterfield, VA 23834
Phone (804) 520-2600

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13560/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1188432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188432000000",
    "number": "1972797256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16011 KAIROS RD",
            "address_2": "SUITE 'A'",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238345205",
            "telephone_number": "804-520-2600",
            "fax_number": "604-520-5853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16011 KAIROS RD",
            "address_2": "SUITE 'A'",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238345205",
            "telephone_number": "804-520-2600",
            "fax_number": "604-520-5853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLONIAL HEIGHTS PEDIATRICS LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-30",
        "last_updated": "2007-08-30",
        "status": "A",
        "authorized_official_last_name": "IQBAL",
        "authorized_official_first_name": "JAWED",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "804-520-2600",
        "authorized_official_credential": "M.D.,"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G62833",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G61226",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Petersburg Children Clinic",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Colonial Heights, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2007; 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.