PEDIATRIC ASSOC OF PETERSBURG (NPI# 1457571754) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457571754 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC ASSOC OF PETERSBURG |
| Other Organization Name | INFANT JESUS CHILDRENS CLINIC |
| Practice Address |
13213 Rivers Bend Blvd Chester VA 23836-8606 |
| Practice Telephone | 8045307413 |
| Practice Fax Number | 8045307411 |
| Mailing Telephone | 8045307413 |
| Mailing Fax Number | 8045307411 |
| Enumeration Date | 2007-04-27 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | PATRICIA D GONZALES (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 8045307413 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 0101026123 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OPTIMUM CHOICE DR HERMES | 213114 | 01 | |
| ALLIANCE PPO DR TAMARA CH | 2134065 | 01 | |
| SOUTHERN HEALTH DR PATRIC | 266582 | 01 | |
| CIGNA DR HERMES DIZON | 6674705 | 01 | |
| SENTARA OPTIMA HEALTH DR | 13767 | 01 | |
| MAMSI DR PATRICIA GONZALE | 2100405 | 01 | |
| OPTIMUM CHOICE DR TAMARA | 2134065 | 01 | |
| VA | ANTHEM BLUE CROSS | 466594 | 01 |
| SENTARA OPTIMA HEALTH DR | 23468 | 01 | |
| SOUTHERN HEALTH DR HERMES | 306087 | 01 | |
| CARENET DR TAMARA CHARITY | 57968 | 01 | |
| MDIPA DR TAMARA CHARITY B | 2134065 | 01 | |
| CARENET DR PATRICIA GONZA | 5293 | 01 | |
| UNITED HEALTHCARE DR HERM | 002478499004 | 01 | |
| CIGNA DRPATRICIA GONZALES | 1243417 | 01 | |
| VA | OPTIMA HEALTH MEDICAID HM | 13767 | 01 |
| MDIPA DR HERMES DIZON | 213114 | 01 | |
| AETNA DRPATRICIA GONZALES | 4365024 | 01 | |
| UNITED HEALTHCARE DR PATR | 1201542 | 01 | |
| CIGNA DR TAMARA CHARITY B | 6657468 | 01 |
| Other Name | Type Code |
|---|---|
| Infant Jesus Childrens Clinic | Doing Business As Name - Organization |
| Street Address |
13213 RIVERS BEND BLVD |
| City | CHESTER |
| State | VA |
| Zip Code | 23836-8606 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609376086 | Sheila Hautbois | Physician Assistant | 228 Johnson Creek Dr., Chester, VA 23836 | 2018-02-13 |
| 1225466386 | Linda Hamilton | Pharmacist | 204 Thornhill Drive, Chester, VA 23836 | 2013-10-28 |
| 1124383161 | Salimata Keita | Home Health Aide | 13701 River Tree, Chester, VA 23836 | 2012-07-05 |
| 1003032541 | Goradia Orthopedics, Pllc | Clinic/Center | 281 East Hundred Rd, Chester, VA 23836 | 2007-04-17 |
| 1427181890 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 221 E. Hundred Road, Chester, VA 23836 | 2007-03-14 |
| 1598871659 | Tushar C Shah | Family Medicine | 13121 Rivers Bend Blvd, Chester, VA 23836 | 2006-08-22 |
| 1558382994 | Clifford Vincent Morris | Internal Medicine | 228 Johnson Creek Drive, Chester, VA 23836 | 2006-07-21 |
| 1891234886 | Sherika Adrian Jones | Nurse Practitioner | 221 E Hundred Rd, Chester, VA 23836 | 2017-02-23 |
| 1467734863 | Morris Cardiovascular and Risk Reduction Center PC | Internal Medicine | 228 Johnson Creek Drive, Chester, VA 23836 | 2011-09-13 |
| 1346881067 | Zenith Diagnostics, Inc. | Clinical Medical Laboratory | 13042 Rivers Bend Road, Chester, VA 23836-2383 | 2019-10-03 |
| Find all providers in zip 23836 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| 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. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134738644 | Medical University Hospital Authority | Pediatrics | 1 Medical Park Dr Ste A, Chester, SC 29706-9769 | 2020-07-30 |
| 1497248173 | Danielle Elaine Senn | Pediatrics | 1 Medical Center Blvd Bldg 1, Chester, PA 19013-3902 | 2018-06-07 |
| 1265828958 | Jennifer Trosko Higgins | Pediatrics | 30 Medical Center Blvd Ste 205, Chester, PA 19013-3957 | 2015-04-09 |
| 1609145663 | Gwen Marie Bogacki | Pediatrics | 2 Fieldcrest Rd, Chester, NJ 07930-2655 | 2011-12-21 |
| 1780974709 | Amrit Bhardwaj | Pediatrics | 1 Medical Center Blvd Ste 205, Chester, PA 19013-3902 | 2011-04-11 |
| 1992849558 | Daniel O. Dada | Pediatrics | 230 E 24th St, Chester, PA 19013-4634 | 2007-02-16 |
| 1598834152 | Elizabeth Madeline Bird | Pediatrics | 20 Water St, Chester, CT 06412 | 2006-11-07 |
| 1598851230 | Laina Jo Bourassa | Pediatrics | 4707 Buckingham Ct, Chester, VA 23831-4261 | 2006-10-04 |
| 1003823931 | Marion Logan Gibbons | Pediatrics | 1 Medical Park Drive, Building 3, Suite A, Chester, SC 29706-9769 | 2006-08-02 |
| 1194777995 | Salud Urtula Tiro | Pediatrics | 125 E 9th St, Chester, PA 19013-6019 | 2006-05-17 |
| Find all providers in CHESTER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.