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INTEGRATIVE PEDIATRIC HEALTH CARE LLC NPI 1902275712


NPI Information

NPI: 1902275712
Provider Name: INTEGRATIVE PEDIATRIC HEALTH CARE, LLC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 06D2104937

Address:
3540 S POPLAR ST STE 202
DENVER, CO
ZIP 80237
Phone: (720) 442-3615
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INTEGRATIVE PEDIATRIC HEALTH CARE, LLC is a primary care clinic center in Denver, CO. INTEGRATIVE PEDIATRIC HEALTH CARE, LLC NPI is 1902275712. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

3540 S POPLAR ST STE 202
DENVER, CO
ZIP 80237-362
Phone: (720) 442-3615
Fax: (720) 870-3726

The provider's authorized official is Jennifer Gaughan .
The authorized official title is Member, Practitioner and has the following contact phone number (719) 494-5123.

The CLIA number assigned to this NPI record is 06D2104937 - other - pediatric nurse pract with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/22/2015 and was last updated on 2/3/2021.


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
1363LP0200XNurse PractitionerPediatricsNo
2261QP2300XClinic/CenterPrimary CareYes

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
110820051MEDICAIDCOLORADO

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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