CENTRAL PEDIATRICS, P.A. – NPI #1396721387
Clinic/Center

CENTRAL PEDIATRICS, P.A. is an AHC clinic located in WOODBURY, MN. NPPES has assigned the NPI number 1396721387 to CENTRAL PEDIATRICS, P.A. on December 21, 2005. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QP2300X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Primary Care

The NPI profile was previously updated about 4 years ago on Jul 21, 2022. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CENTRAL PEDIATRICS, P.A. below.

NPI Profile for
CENTRAL PEDIATRICS, P.A.

NPI Number
1396721387
Enumeration Date

(more than 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CENTRAL PEDIATRICS, P.A.
Primary location
9680 TAMARACK RD STE 100
WOODBURY, MN 55125-2623
Phone: (651) 738-0470 Fax: (651) 731-5031
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
KIM ALTENDORF
ADMINISTRATOR
Phone: (651) 731-5026
Updated
Certification Date
Jan 29, 2020

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QP2300X
- Clinic/Center / Primary Care (Primary)		 MN

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.