Pediatrics West, P.C.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

PEDIATRICS WEST, P.C.

Practice address

3555 Lutheran Parkway
Suite 200
Wheat Ridge, CO 80033-6027

Phone

(720) 284-3700

Fax

(303) 467-0525

NPI assigned

Jul 14, 2006

Last updated

Jun 12, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Tym C Johnson, MBA

Title

Practice Administrator

Phone

(720) 284-3708

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Pediatrics West PC2 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.

• Pediatrics West, P.C.

  • Primary Care Clinic/Center
  • Littleton, CO
  • NPI 1518582865
  NPD tax ID

Locations

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.

• Pediatrics West, P.C.

  • Primary Care Clinic/Center
  • Littleton, CO
  • NPI 1518582865
  NPPES parent name

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591920000000",
    "number": "1275559569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3555 LUTHERAN PARKWAY",
            "address_2": "SUITE 200",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800336027",
            "telephone_number": "720-284-3700",
            "fax_number": "303-467-0525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 LUTHERAN PARKWAY",
            "address_2": "SUITE 200",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800336027",
            "telephone_number": "720-284-3700",
            "fax_number": "303-467-0525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13402 W Coal Mine Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Littleton",
            "state": "CO",
            "postal_code": "801275407",
            "country_code": "US",
            "telephone_number": "720-284-3700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PEDIATRICS WEST, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-14",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "TYM",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "720-284-3708",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08683778",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Peak Form LLC
• Peak Pediatrics PLLC (Peak Pediatrics)
• Kelly J Pearson, PA
• Timbree May Pederson, LCSW
• Pediatric Dental Group of Wheat Ridge
• Robert Carl Pekrul III
• Starlene S Peluso
• Jacqueline Pena-Sosa
• Gabriela Pena
• Lauren Pennartz, NP-C

• Primary Care Clinic/Center in Wheat Ridge, CO
• Providers in Wheat Ridge, CO by specialty
• Primary Care Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.