NPIMap

Organization Active NPI

Arvada Pediatric Associates, PC

  • Pediatrics Physician
  • Arvada, CO
National Provider Identifier
1215084652
Registry record updated Jul 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
ARVADA PEDIATRIC ASSOCIATES, PC
Practice address
8030 Lee Dr
Arvada, CO 80005-2078
Phone
(303) 421-6873
Fax
(303) 421-9922
NPI assigned
Jan 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2016

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

Authorized official

Name
Dr. Charyl B. Leblanc, M.D.NPI 1649329509
Title
President
Phone
(303) 421-6873

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

8030 Lee Dr
Arvada, CO 80005-2078

Mailing address

8030 Lee Dr
Arvada, CO 80005-2078
Phone (303) 421-6873

Other identifiers 1

IdentifierTypeStateIssuer
04126041MedicaidCO

Other names 1

  • Arvada Pediatric Associates, PC Doing business as

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
06D0510287Arvada Pediatric Associates8030 Lee Drive, Arvada, CO 80005Provider-performed microscopyNov 1, 2026

National Provider Directory

National Provider Directory
Tax ID family
Arvada Pediatric2 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.

Locations

8030 Lee Dr
Arvada, CO 80005
Phone (303) 421-6873

3830 W 121st Pl
Broomfield, CO 80020
Phone (303) 410-8041

Practitioners & affiliated clinicians

Practitioners 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468195200000",
    "number": "1215084652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8030 LEE DR",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800052078",
            "telephone_number": "303-421-6873",
            "fax_number": "303-421-9922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8030 LEE DR",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800052078",
            "telephone_number": "303-421-6873",
            "fax_number": "303-421-9922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARVADA PEDIATRIC ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2016-07-11",
        "status": "A",
        "authorized_official_last_name": "LEBLANC",
        "authorized_official_first_name": "CHARYL",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "303-421-6873",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "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": "04126041",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arvada Pediatric Associates, PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Arvada, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2016; 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.