Healthcare Provider Details

I. General information

NPI: 1700792900
Provider Name (Legal Business Name): PEAPOD PEDIATRICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5010 E SHEA BLVD STE 148
SCOTTSDALE AZ
85254-4751
US

IV. Provider business mailing address

5010 E SHEA BLVD STE 148
SCOTTSDALE AZ
85254-4751
US

V. Phone/Fax

Practice location:
  • Phone: 480-568-2041
  • Fax: 480-761-3147
Mailing address:
  • Phone: 480-568-2041
  • Fax: 480-761-3147

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: SARAH ELISABETH WIERSMA
Title or Position: OWNER
Credential: MD
Phone: 480-568-2041