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PRAIRIE PEDIATRICS PC NPI 1306920319


NPI Information

NPI: 1306920319
Provider Name: PRAIRIE PEDIATRICS, PC

Doing Business As: PRAIRIE PEDIATRICS & ADOLESCENT CLINIC, PC

Classification: Pediatrics - 2080P0202X
Entity Type: Organization

Specialization: Pediatric Cardiology

CLIA Number: 16D0385234

Address:
1125 PIERCE ST
SIOUX CITY, IA
ZIP 51105
Phone: (712) 255-8901
Get Directions

PRAIRIE PEDIATRICS, PC is a pediatric cardiology pediatrics in Sioux City, IA. The provider is a pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease. PRAIRIE PEDIATRICS, PC NPI is 1306920319. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Prairie Pediatrics & Adolescent Clinic, Pc.

The provider's business location address is:

1125 PIERCE ST
SIOUX CITY, IA
ZIP 51105-485
Phone: (712) 255-8901
Fax: (712) 255-9161

The provider's authorized official is Melanie Olsen .
The authorized official title is Business Manager and has the following contact phone number (712) 255-8901.

The CLIA number assigned to this NPI record is 16D0385234 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 10/25/2006 and was last updated on 1/27/2015.


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
12080P0202XPediatricsPediatric CardiologyYes

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
151104A001OTHERIOWATRICARE ENTITY ID
271992MEDICARE PINIOWA

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

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