Provider Type Icon

PEDIATRIC PULMONARY & CRITICAL CARE PC NPI 1225169196


NPI Information

NPI: 1225169196
Provider Name: PEDIATRIC PULMONARY & CRITICAL CARE, PC
Classification: Pediatrics - 2080P0214X
Entity Type: Organization

Specialization: Pediatric Pulmonology

Address:
7910 WEST JEFFERSON BLVD.
STE 205
FORT WAYNE, IN
ZIP 46804
Phone: (260) 435-7800
Get Directions

PEDIATRIC PULMONARY & CRITICAL CARE, PC is a pediatric pulmonology pediatrics in Fort Wayne, IN. The provider is a pediatrician dedicated to the prevention and treatment of all respiratory diseases affecting infants, children and young adults. This specialist is knowledgeable about the growth and development of the lung, assessment of respiratory function in infants and children, and experienced in a variety of invasive and noninvasive diagnostic techniques. PEDIATRIC PULMONARY & CRITICAL CARE, PC NPI is 1225169196. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

7910 WEST JEFFERSON BLVD.
STE 205
FORT WAYNE, IN
ZIP 46804-159
Phone: (260) 435-7800
Fax: (260) 435-7007

The provider's authorized official is Chandrashekhar Chowdary Yalamanchali .
The authorized official title is Owner/president and has the following contact phone number (260) 435-7800.

The enumeration date for this NPI number is 3/9/2007 and was last updated on 3/6/2012.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12080P0203XPediatricsPediatric Critical Care Medicine01049779AINDIANANo
2208000000XPediatricsNo
32080P0203XPediatricsPediatric Critical Care MedicineNo
42080P0214XPediatricsPediatric PulmonologyNo
52080P0214XPediatricsPediatric Pulmonology01049779AINDIANAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1200500220MEDICAIDINDIANA
2200231310MEDICAIDINDIANA
3200246880MEDICAIDINDIANA

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: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.