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PEDIATRIC ASSOC OF PETERSBURG NPI 1457571754


NPI Information

NPI: 1457571754
Provider Name: PEDIATRIC ASSOC OF PETERSBURG

Doing Business As: INFANT JESUS CHILDRENS CLINIC

Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
13213 RIVERS BEND BLVD
CHESTER, VA
ZIP 23836
Phone: (804) 530-7413
Get Directions

PEDIATRIC ASSOC OF PETERSBURG is a pediatrics in Chester, VA. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. PEDIATRIC ASSOC OF PETERSBURG NPI is 1457571754. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Infant Jesus Childrens Clinic.

The provider's business location address is:

13213 RIVERS BEND BLVD
CHESTER, VA
ZIP 23836-606
Phone: (804) 530-7413
Fax: (804) 530-7411

The provider's authorized official is Patricia D Gonzales .
The authorized official title is Medical Director and has the following contact phone number (804) 530-7413.

The enumeration date for this NPI number is 4/27/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208000000XPediatrics0101026123VIRGINIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1213114OTHEROPTIMUM CHOICE DR HERMES
22134065OTHERALLIANCE PPO DR TAMARA CH
3266582OTHERSOUTHERN HEALTH DR PATRIC
46674705OTHERCIGNA DR HERMES DIZON
513767OTHERSENTARA OPTIMA HEALTH DR
62100405OTHERMAMSI DR PATRICIA GONZALE
72134065OTHEROPTIMUM CHOICE DR TAMARA
8466594OTHERVIRGINIAANTHEM BLUE CROSS
923468OTHERSENTARA OPTIMA HEALTH DR
10306087OTHERSOUTHERN HEALTH DR HERMES
1157968OTHERCARENET DR TAMARA CHARITY
122134065OTHERMDIPA DR TAMARA CHARITY B
135293OTHERCARENET DR PATRICIA GONZA
14002478499004OTHERUNITED HEALTHCARE DR HERM
151243417OTHERCIGNA DRPATRICIA GONZALES
1613767OTHERVIRGINIAOPTIMA HEALTH MEDICAID HM
17213114OTHERMDIPA DR HERMES DIZON
184365024OTHERAETNA DRPATRICIA GONZALES
191201542OTHERUNITED HEALTHCARE DR PATR
206657468OTHERCIGNA DR TAMARA CHARITY B

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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