NPIMap

Organization Active NPI

Mountainland Pediatrics PC

  • Pediatrics Physician
  • Denver, CO
National Provider Identifier
1174605489
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
MOUNTAINLAND PEDIATRICS PC
Practice address
8889 Fox Drive
Suite a
Denver, CO 80260-8842
Phone
(303) 430-0823
Fax
(303) 426-9581
NPI assigned
Oct 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Susan E Spoerke, MDNPI 1902980576
Title
President/Ceo
Phone
(303) 430-0823

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

8889 Fox Drive
Suite a
Denver, CO 80260-8842

Mailing address

8889 Fox Drive
Suite a
Denver, CO 80260-8842
Phone (303) 430-0823

Other identifiers 2

IdentifierTypeStateIssuer
04008363MedicaidCO
0600672594OtherCOCLIA

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.61114

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174605489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8889 FOX DRIVE",
            "address_2": "SUITE A",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802608842",
            "telephone_number": "303-430-0823",
            "fax_number": "303-426-9581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8889 FOX DRIVE",
            "address_2": "SUITE A",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802608842",
            "telephone_number": "303-430-0823",
            "fax_number": "303-426-9581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAINLAND PEDIATRICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SPOERKE",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "303-430-0823",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04008363",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "0600672594",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.