Individual provider Active NPI

Antonia Jill Sigl, M.D.

  • Pediatrics Physician
  • Johnstown, CO
National Provider Identifier
1043665730
Registry record updated Dec 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
DR.0062379 Issued in CO
Practice address
4435 Ronald Reagan Blvd
Johnstown, CO 80534-6409
Phone
(970) 619-8139
NPI assigned
Apr 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X DR.0062379 CO Primary

Addresses

Primary practice location

4435 Ronald Reagan Blvd
Johnstown, CO 80534-6409

Mailing address

4435 Ronald Reagan Blvd
Johnstown, CO 80534-6409
Phone (970) 619-8139

Other names 1

  • Antonia Jill Jacob Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DR.0062379COMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thompson River Pediatrics and Urgent Care, LLC Pediatrics PastSince Sep 1, 2019 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1461888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575590400000",
    "number": "1043665730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4435 RONALD REAGAN BLVD",
            "city": "JOHNSTOWN",
            "state": "CO",
            "postal_code": "805346409",
            "telephone_number": "970-619-8139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4435 RONALD REAGAN BLVD",
            "city": "JOHNSTOWN",
            "state": "CO",
            "postal_code": "805346409",
            "telephone_number": "970-619-8139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIGL",
        "first_name": "ANTONIA",
        "middle_name": "JILL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-29",
        "last_updated": "2019-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "DR.0062379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANTONIA",
            "last_name": "JACOB",
            "middle_name": "JILL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Johnstown, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2019; 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.