Organization Active NPI

Rocky Mountain Health Centers Pediatrics, PC

  • Pediatric Adolescent Medicine Physician
  • Aurora, CO
National Provider Identifier
1063614535
Registry record updated Feb 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
23399 Issued in CO
Legal business name
ROCKY MOUNTAIN HEALTH CENTERS PEDIATRICS, PC
Practice address
14001 E Iliff Ave Ste 210
Aurora, CO 80014-1425
Phone
(303) 996-9691
Fax
(303) 369-2605
NPI assigned
Jun 5, 2007
Last updated
Feb 22, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2021

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

Authorized official

Name
Alison Renee Thaler
Title
Office Manager
Phone
(303) 996-9601

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080A0000X 23399 CO Primary

Addresses

Primary practice location

14001 E Iliff Ave Ste 210
Aurora, CO 80014-1425

Mailing address

14001 E Iliff Ave Ste 210
Aurora, CO 80014-1425
Phone (303) 996-9601

Other identifiers 1

IdentifierTypeStateIssuer
10338381MedicaidCO

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D0514689Rocky Mountain Health Centers PC14001 E Iliff Ave, Aurora, CO 80014Certificate of waiverJan 26, 2028

National Provider Directory

National Provider Directory

Locations

14001 E Iliff Ave
Ste 10
Aurora, CO 80014

14001 E Iliff Ave
Aurora, CO 80014
Phone (303) 745-0809

14001 E Iliff Ave
Ste 210
Aurora, CO 80014
Phone (303) 996-9601

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613952000000",
    "number": "1063614535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14001 E ILIFF AVE STE 210",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800141425",
            "telephone_number": "303-996-9601",
            "fax_number": "303-369-2605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14001 E ILIFF AVE STE 210",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800141425",
            "telephone_number": "303-996-9691",
            "fax_number": "303-369-2605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKY MOUNTAIN HEALTH CENTERS PEDIATRICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-05",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A",
        "authorized_official_last_name": "THALER",
        "authorized_official_first_name": "ALISON",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "303-996-9601"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "CO",
            "license": "23399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10338381",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.