Holistic Developmental Peds & Integrative Med, PLLC · Developmental - Behavioral Pediatrics Physician

4940 Broadway Ste 100, San Antonio, TX 78209-5732

Overview

Holistic Developmental Peds & Integrative Med, PLLC is a Developmental - Behavioral Pediatrics Physician (organization) practicing in San Antonio, Texas. The National Provider Identifier (NPI) is #1033925789, which was assigned on December 7, 2024, and the registration record was last updated on December 7, 2024. The practitioner's main practice location is at 4940 Broadway Ste 100, San Antonio, TX 78209-5732; the contact telephone number is 2104032343, and the fax number is 2104032350. The primary taxonomy of Holistic Developmental Peds & Integrative Med, PLLC is Developmental - Behavioral Pediatrics Physician (2080P0006X), with specialization in Developmental - Behavioral Pediatrics. The authorized official for Holistic Developmental Peds & Integrative Med, PLLC is Dr. Jeri L Penkava (President).

A developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development.

Provider Information

NPI 1033925789
Entity Type Organization
Organization Name HOLISTIC DEVELOPMENTAL PEDS & INTEGRATIVE MED, PLLC
Provider Name HOLISTIC DEVELOPMENTAL PEDS & INTEGRATIVE MED, PLLC
Practice Address 4940 Broadway Ste 100
San Antonio
TX 78209-5732
Practice Telephone 2104032343
Practice Fax Number 2104032350
Mailing Address 4940 Broadway Ste 100
San Antonio
TX 78209-5732
Mailing Telephone 2104032343
Mailing Fax Number 2104032350
Certification Date 2024-12-07
Enumeration Date 2024-12-07
Last Update Date 2024-12-07
Is Organization Subpart N

Authorized Official Information

Official Name DR. JERI L PENKAVA
Official Title PRESIDENT
Credential MD
Telephone 2108672343

Taxonomy and Licenses

PrimaryCodeClassificationSpecializationTaxonomy GroupLicense NumberLicense State
N101YP2500XCounselorProfessional193200000X MULTI-SPECIALTY GROUP
N208000000XPediatrics193200000X MULTI-SPECIALTY GROUP
Y2080P0006XPediatricsDevelopmental - Behavioral Pediatrics193200000X MULTI-SPECIALTY GROUP

Taxonomy Information

Primary Taxonomy

Code 2080P0006X
Taxonomy Developmental - Behavioral Pediatrics Physician
Classification Pediatrics
Specialization Developmental - Behavioral Pediatrics
Grouping Allopathic & Osteopathic Physicians
Definition: A developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed, 3/26/2008: definition corrected] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics.

Other Taxonomy

Code 101YP2500X
Taxonomy Professional Counselor
Classification Counselor
Specialization Professional
Grouping Behavioral Health & Social Service Providers
Definition: Definition to come...

Other Taxonomy

Code 208000000X
Taxonomy Pediatrics Physician
Classification Pediatrics
Grouping Allopathic & Osteopathic Physicians
Definition: 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.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio
Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics.

Providers with the same taxonomy

Provider NameAddressTaxonomyEnumeration Date
Kerri Duncan, LLC 8591 Lakeside Dr, Englewood, FL 34224Developmental - Behavioral Pediatrics Physician2024-12-09
Sptlsc Inc 110 S Orange St, New Smyrna Beach, FL 32168-7153Developmental - Behavioral Pediatrics Physician2024-06-20
Little Miracles Ppec LLC 11025 Sw 84th St Ste 9, Miami, FL 33173-3856Developmental - Behavioral Pediatrics Physician2024-11-06
Ladder Health Inc 817 Broadway Fl 7, New York, NY 10003-4709Developmental - Behavioral Pediatrics Physician2024-07-10
Marylynn Charnas 4 Hampshire Ct, Monticello, NY 12701-8463Developmental - Behavioral Pediatrics Physician2024-06-28
Paige Zalewski 109 N Stadium Blvd Apt 35, Columbia, MO 65203-8161Developmental - Behavioral Pediatrics Physician2024-12-03
Samantha Cohen, Md, Inc. 3405 Kenyon St Ste 210, San Diego, CA 92110-5005Developmental - Behavioral Pediatrics Physician2024-06-25
Created To Thrive, PLLC 6922 W Rayford Rd Ste 200, Spring, TX 77389-3004Developmental - Behavioral Pediatrics Physician2024-07-17
April D Christopherson Otr L LLC 457 Main St, Delta, CO 81416-1816Developmental - Behavioral Pediatrics Physician2024-12-16
Jacqueline Kramer 1150 Portion Rd Ste 11, Holtsville, NY 11742-1074Developmental - Behavioral Pediatrics Physician2024-07-26
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Location Information

Street Address 4940 BROADWAY STE 100
City SAN ANTONIO
State TX
Zip Code 78209-5732
Country US

Providers in the same location

Provider NameAddressTaxonomyEnumeration Date
Adhd Plus 4940 Broadway Ste 100, San Antonio, TX 78209-5732Counselor2022-08-15

Providers in the same zip code

Provider NameAddressTaxonomyEnumeration Date
John Pichot 4940 Broadway Ste 211, San Antonio, TX 78209-5732Psychiatry Physician2006-09-12
Mark Pichot 4940 Broadway Ste 211, San Antonio, TX 78209-5732Student in an Organized Health Care Education/Training Program2017-06-08
Randy Markey 4940 Broadway St Ste 139, San Antonio, TX 78209-5732Clinical Social Worker2006-03-24
Abigail Elizabeth Talley 4940 Broadway Ste 211, San Antonio, TX 78209-5732Psychiatry Physician2017-03-28
Marcella Eloise Quesada · Marcella Eloise Lopez 4940 Broadway Street, Suite 112, San Antonio, TX 78209-5732Mental Health Counselor2007-03-05

Providers in the same zip code

Provider NameAddressTaxonomyEnumeration Date
Brenda M. Kramer · Brenda Kramer 8700 Crowhill Blvd, San Antonio, TX 78209Licensed Vocational Nurse2022-01-09
Argentina Balderrama 343 Larchmont Dr., San Antonio, TX 78209Social Worker2016-08-02
Leslie Stark Lewis 1635 Ne Interstate 410 Loop, Ste 600, San Antonio, TX 78209Speech-Language Pathologist2021-07-01
Westlake Dermatology, Pa 5500 Broadway Ave, Alamo Heights, TX 78209Dermatology Physician2019-07-30
Jessica Michelle Moore 8400 Crown Hill Blvd, San Antonio, TX 78209Licensed Vocational Nurse2018-08-20
John Paul White 1635 Ne Interstate 410 Loop #600, San Antonio, TX 78209Physical Therapist2023-02-17
Blue Laser Surgical Company, PLLC 813 College Blvd, San Antonio, TX 78209Surgical Physician Assistant2016-08-03
Passport Health Holdings, LLC 1100 Ne Interstate 410 Loop, Suite 410, San Antonio, TX 78209Community Health Worker2023-06-02
Mckenna R Ayers 1635 Ne Interstate 410 Loop (Suite 600), San Antonio, TX 78209Occupational Therapist2024-12-05
Olawunmi Olapeju Odele 8700 Crownhill Blvd. Ste.300, San Antonio, TX 78209Licensed Vocational Nurse2018-08-12
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Dataset Information

This dataset includes over five million health care providers who are assigned National Provider Identifier (NPI) in the National Plan and Provider Enumeration System (NPPES), developed by the Centers for Medicare & Medicaid Services (CMS). Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under Health Insurance Portability and Accountability Act (HIPAA). Each provider is registered with the NPI, full name, status, address, taxonomy, other identifiers, etc.

Subject Transparency and Disclosure
Jurisdiction Federal
Data Provider National Plan and Provider Enumeration System (NPPES), by the Centers for Medicare & Medicaid Services (CMS)
Source download.cms.gov

Dataset Details

The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers and all health plans and health care clearinghouses, who must use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number).

All health care providers who are HIPAA-covered entities, whether individuals or organizations, must get an NPI. A HIPAA-covered entity is a health care provider that conducts certain transactions in electronic form, or a health care clearinghouse, or a health plan (including commercial plans, Medicare, and Medicaid).

Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign unique identifiers to health care providers. The National Provider Indentifier (NPI) has been the standard identifier for all HIPAA-covered entities (health care providers) since May 23, 2007. Small health plans were required to obtain and use an NPI by May 23, 2008.

This dataset includes over five million health care providers (individuals and organizations) who are assigned NPI. The provider data elements are disclosed to the public by the Centers for Medicare & Medicaid Services (CMS) under the Freedom of Information Act (FOIA), as listed in the NPPES Data Dissemination Notice (CMS-6060-N). The NPI final rules define the following elements which required to be disclosed as determined by Department of Health & Human Services (HHS): NPI, Entity Type, Provider Name, Credential, Business Mailing Address, Business Location Address, Healthcare Provider Taxonomy Code, Other Provider Identifier, Provider Enumeration Date, NPI Deactivation Date, Provider License Number, Authorized Official Name and Contact Information.