JACKSON PEDIATRICS – NPI #1912335530
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.

Health Care Provider Taxonomy Code for Pediatrics

JACKSON PEDIATRICS is a provider located in JACKSON, WY. NPPES has assigned the NPI number 1912335530 to JACKSON PEDIATRICS on October 16, 2013. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “JACKSON PEDIATRICS” is a dba name, the actual legal business name for this organization is JACKSON PEDIATRIC ASSOCIATES, LLC. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 208000000X from the Health Care Provider Taxonomy code set, which is classified as Pediatrics.

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 JACKSON PEDIATRICS below.

NPI Profile for
JACKSON PEDIATRIC ASSOCIATES, LLC

NPI Number
1912335530
Enumeration Date

(more than 12 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
JACKSON PEDIATRIC ASSOCIATES, LLC
Doing Business As (dba): JACKSON PEDIATRICS
Primary location
557 E BROADWAY AVE
JACKSON, WY 83001-8640
Phone: (307) 733-4627 Fax: (307) 733-5184
Mailing address
PO BOX 1029
JACKSON, WY 83001-1029
Phone: (307) 733-4627 Fax: (307) 733-5184
Organization Subpart
No
Authorized Official
TRAVIS RIDDELL
PEDIATRICIAN
Phone: (307) 733-4627
Updated
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
208000000X
- Pediatrics (Primary)
261QP2300X
- Clinic/Center / Primary Care

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.