NPIMap

Organization Active NPI

Pediatric and Adolescent Medicine Associates PC

  • Primary Care Clinic/Center
  • Parker, CO
National Provider Identifier
1043633647
Registry record updated Feb 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
433 Issued in CO
Legal business name
PEDIATRIC AND ADOLESCENT MEDICINE ASSOCIATES PC
Practice address
9235 Crown Crest Blvd
Suite 100
Parker, CO 80138-8880
Phone
(303) 695-7667
Fax
(303) 695-8146
NPI assigned
Feb 3, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. David B. Roos, M.D.
Title
Presidentt
Phone
(303) 695-7667

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 433 CO Primary

Addresses

Primary practice location

9235 Crown Crest Blvd
Suite 100
Parker, CO 80138-8880

Mailing address

9235 Crown Crest Blvd
Suite 100
Parker, CO 80138-8880
Phone (303) 695-7667

Other identifiers 1

IdentifierTypeStateIssuer
04009304MedicaidCO

Other names 1

  • Crown Point Pediatrics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Crown Point Pediatrics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1391385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391385600000",
    "number": "1043633647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9235 CROWN CREST BLVD",
            "address_2": "SUITE 100",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801388880",
            "telephone_number": "303-695-7667",
            "fax_number": "303-695-8146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9235 CROWN CREST BLVD",
            "address_2": "SUITE 100",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801388880",
            "telephone_number": "303-695-7667",
            "fax_number": "303-695-8146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC AND ADOLESCENT MEDICINE ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-03",
        "last_updated": "2014-02-03",
        "status": "A",
        "authorized_official_last_name": "ROOS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PRESIDENTT",
        "authorized_official_telephone_number": "303-695-7667",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CO",
            "license": "433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04009304",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crown Point Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Parker, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.