JOHN NICK PETELOS M.D. NPI 1255350963

NPI Information

NPI: 1255350963
Provider Name: JOHN NICK PETELOS, M.D.
Classification: Pediatrics - 208000000X
Entity Type: Individual
Address:
5295 PRESERVE PARKWAY
SUITE 100
HOOVER, AL
ZIP 35244
Phone: (205) 987-4444
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John Nick Petelos, M.D. is a pediatrics in Hoover, AL. 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. John Nick Petelos, M.D. NPI is 1255350963. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

5295 PRESERVE PARKWAY
SUITE 100
HOOVER, AL
ZIP 35244
Phone: (205) 987-4444
Fax: (205) 987-4451

The enumeration date for this NPI number is 7/19/2006 and was last updated on 1/4/2016.

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
1	208000000X	Pediatrics		11468	ALABAMA	Yes

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
1	51026579	OTHER	ALABAMA	BLUE CROSS OF ALABAMA
2	51510837	OTHER	ALABAMA	BLUE CROSS OF ALABAMA
3	000026579	MEDICAID	ALABAMA
4	D53288	MEDICARE UPIN
5	009911025	MEDICAID	ALABAMA

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

NPI Synchronization or Removal

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