Individual provider Active NPI

Susan Boackle Childress, MD

  • Rheumatology Physician
  • Englewood, CO
National Provider Identifier
1235229915
Registry record updated Jan 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
CDRH.0035598 Issued in CO
Practice address
3601 S Pennsylvania St Ste B
Englewood, CO 80113-3753
Phone
(720) 262-2462
NPI assigned
Oct 13, 2006
Last updated
Jan 25, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2026

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 70477 AZ
Rheumatology Physician 207RR0500X CDRH.0035598 CO Primary
Rheumatology Physician 207RR0500X MD.43902 AL
Rheumatology Physician 207RR0500X 335634 LA
Rheumatology Physician 207RR0500X MD28095 ME
Rheumatology Physician 207RR0500X H7909 TX

Addresses

Primary practice location

3601 S Pennsylvania St Ste B
Englewood, CO 80113-3753

Mailing address

2459 S Chase LN
Lakewood, CO 80227-3902

Other identifiers 1

IdentifierTypeStateIssuer
01355981MedicaidCO

Other names 1

  • Susan Angelle Boackle Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, AZ, ME3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20040802000706 CO Practitioner - RheumatologyPractitioner - Internal Medicine 3476524752 Reassigns benefits to 1 organization
I20230626000211 AZ Practitioner - Rheumatology 3476524752 Reassigns benefits to 1 organization
I20240529001175 ME Practitioner - Rheumatology 3476524752 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Benson Hospital CorporationGroup PAC ID 3274443056, 20 clinicians

Practice addresses (Care Compare)

450 S Ocotillo Ave
Benson, AZ 85602-6403
Phone (520) 586-2261

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD.43902ALMDRheumatology Physician
CDRH.0035598COMDRheumatology Physician
MD28095MEMDRheumatology Physician
H7909TXMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph Hospital CurrentSince May 1, 2024 Accepting new patients
Benson Hospital Corporation CurrentSince Jul 1, 2023 Accepting new patients
Benson Hospital Corporation CurrentSince Jul 1, 2023 Accepting new patients
Denver Health and Hospital Authority CurrentSince Feb 1, 2015 Accepting new patients
St. Charbel Health, PLLC Rheumatology CurrentSince Dec 7, 2025 Accepting new patients
Denver Health and Hospital Authority CurrentSince Feb 1, 2015 Accepting new patients
Benson Hospital Corporation Past Accepting new patients

Locations

450 S Ocotillo St
Benson, AZ 85602
Phone (520) 586-2261

688 W 4th St
Ste B
Benson, AZ 85602
Phone (520) 720-6551

777 Bannock St
Denver, CO 80204

3601 S Pennsylvania St
Ste B
Englewood, CO 80113
Phone (720) 262-2462

360 Broadway
#L
Bangor, ME 04401
Phone (207) 262-1703

900 Broadway
Bangor, ME 04401
Phone (207) 907-3300

Interoperability endpoints

  • Direct secure messaging: susan.childress.1@18129.direct.athenahealth.com

Organizations & group practices 7

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

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769299200000",
    "number": "1235229915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2459 S CHASE LN",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802273902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 S PENNSYLVANIA ST STE B",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801133753",
            "telephone_number": "720-262-2462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDRESS",
        "first_name": "SUSAN",
        "middle_name": "BOACKLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2026-01-25",
        "certification_date": "2026-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "AZ",
            "license": "70477",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "CO",
            "license": "CDRH.0035598",
            "primary": true
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "AL",
            "license": "MD.43902",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "LA",
            "license": "335634",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "ME",
            "license": "MD28095",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "TX",
            "license": "H7909",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01355981",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "BOACKLE",
            "middle_name": "ANGELLE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Englewood, CO

Sources for this page

Verify at the official NPI Registry.