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PEDIATRIC AND ADOLESCENT HEALTH
NPI 1619923752
Pediatrics - Adolescent Medicine in Johnson City, NY

Active since May 26, 2006CLIA 33D0695091 · Waiver
639 MAIN ST, JOHNSON CITY, NY 13790(607) 770-1988 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Pediatric And Adolescent Health NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PEDIATRIC AND ADOLESCENT HEALTH (NPI 1619923752) is a healthcare organization registered as an adolescent medicine in Johnson City, New York and active in the NPI registry since May 2006. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists J Roger Chatterton, Physician, as its authorized official.

NPPES Registry Identity

NPI1619923752
Entity TypeOrganization
Primary Taxonomy2080A0000X
Legal Business NamePEDIATRIC AND ADOLESCENT HEALTH
Location Address639 MAIN STJohnson City, NY 13790-1805
Mailing Address639 Main StJohnson City, NY 13790-1805 · (607) 770-1988
Phone(607) 770-1988
Organization SubpartNo
Authorized OfficialJ Roger ChattertonPhysician · (607) 770-1988
Enumeration DateMay 26, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1619923752 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Adolescent MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080A0000X
Definition
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.
639 MAIN ST, Johnson City, NY 13790
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D0695091

Pediatric And Adolescent Health MD PC · Johnson City, NY
Active · expires Aug 31, 2026
CLIA Number33D0695091
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorJ Roger Chatterton
Laboratory Phone(607) 770-1988
Laboratory LocationPediatric And Adolescent Health MD PC639 Main Street, Johnson City, NY 13790
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MISS RUNAK PATEL M.D.
Pediatrics
639 MAIN ST
JOHNSON CITY, NY 13790
Broome County (607) 770-1988
WILLIAM MILLER M.D.
Pediatrics (Adolescent Medicine)
639 MAIN ST
JOHNSON CITY, NY 13790
Broome County (607) 770-1988
ANDREA M SHAUL CPNP
Nurse Practitioner (Pediatrics)
639 MAIN ST
JOHNSON CITY, NY 13790
Broome County (607) 770-1988
DR. DAVID CHANNING CARTER M.D.
Pediatrics
639 MAIN ST
JOHNSON CITY, NY 13790
Broome County (607) 770-9899

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pediatric And Adolescent Health's NPI number?

The NPI number for Pediatric And Adolescent Health is 1619923752. It was assigned to this organization in the NPPES registry on May 26, 2006.

Where is Pediatric And Adolescent Health located?

Pediatric And Adolescent Health is located at 639 Main St, Johnson City, NY 13790. The listed phone number is (607) 770-1988.

What is Pediatric And Adolescent Health's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Adolescent Medicine, with taxonomy code 2080A0000X.

Does Pediatric And Adolescent Health hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D0695091) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Pediatric And Adolescent Health was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.