Organization Active NPI

Sanctuary Pediatrics PLLC

  • Pediatric Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1255158804
Registry record updated May 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
Legal business name
SANCTUARY PEDIATRICS PLLC
Practice address
11590 Ridgeline Dr Ste 140
Colorado Springs, CO 80921-3969
Phone
(719) 726-0765
NPI assigned
Sep 24, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2026

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

Authorized official

Name
Jessica Donaldson, CPNP-PCNPI 1477204758
Title
Owner Provider
Phone
(206) 941-4058

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
Pediatric Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0200X Primary

Addresses

Primary practice location

11590 Ridgeline Dr Ste 140
Colorado Springs, CO 80921-3969

Mailing address

11590 Ridgeline Dr Ste 140
Colorado Springs, CO 80921-3969
Phone (719) 726-0765

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
06D2326810Sanctuary Pediatrics11590 Ridgeline Dr Suite 140, Colorado Springs, CO 80921Certificate of waiverJul 9, 2027

National Provider Directory

National Provider Directory

Locations

11590 Ridgeline Dr
Ste 140
Colorado Springs, CO 80921
Phone (719) 726-0765

Practitioners & affiliated clinicians

Practitioners 1

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": "1727136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779235200000",
    "number": "1255158804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11590 RIDGELINE DR STE 140",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809213969",
            "telephone_number": "719-726-0765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11590 RIDGELINE DR STE 140",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809213969",
            "telephone_number": "719-726-0765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANCTUARY PEDIATRICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-24",
        "last_updated": "2026-05-20",
        "certification_date": "2026-05-20",
        "status": "A",
        "authorized_official_last_name": "DONALDSON",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OWNER PROVIDER",
        "authorized_official_telephone_number": "206-941-4058",
        "authorized_official_credential": "CPNP-PC"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2026; 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.