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CCPARTNERS LLC NPI 1487857033


NPI Information

NPI: 1487857033
Provider Name: CCPARTNERS LLC

Doing Business As: KIDZ BIZ PEDIATRICS

Classification: Pediatrics - 2080A0000X
Entity Type: Organization

Specialization: Adolescent Medicine

CLIA Number: 26D0685556

Address:
35 GOODWIN DR
FESTUS, MO
ZIP 63028
Phone: (636) 933-4141
Get Directions

CCPARTNERS LLC is an adolescent medicine pediatrics in Festus, MO. The provider is a pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. CCPARTNERS LLC NPI is 1487857033. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Kidz Biz Pediatrics.

The provider's business location address is:

35 GOODWIN DR
FESTUS, MO
ZIP 63028-122
Phone: (636) 933-4141
Fax: (636) 931-7007

The provider's authorized official is Joshua Paul Boldt .
The authorized official title is Physician/partner and has the following contact phone number (636) 933-4141.

The CLIA number assigned to this NPI record is 26D0685556 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/8/2007 and was last updated on 2/7/2014.


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
12080A0000XPediatricsAdolescent MedicineYes

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
136393OTHERMISSOURIHEALTHCARE USA
20191OTHERMISSOURIMERCY CARE PLUS
3507593903MEDICAIDMISSOURI
4100301OTHERMISSOURIGROUP HEALTH PLAN

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: 5/5/2024

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