Organization Active NPI

Pamela W. Casson, MD, PC

Doing business as Sunrise Pediatrics

  • Pediatrics Physician
  • Colorado Springs, CO
National Provider Identifier
1477794428
Registry record updated Mar 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PAMELA W. CASSON, MD, PC
Doing business as
Sunrise Pediatrics
Practice address
1465 Kelly Johnson Blvd
Suite 220
Colorado Springs, CO 80920-3955
Phone
(719) 265-1050
Fax
(719) 265-2503
NPI assigned
Mar 19, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2009

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

Authorized official

Name
Dr. Pamela Wallace Casson, M.D.NPI 1851388367
Title
Pediatrician
Phone
(719) 598-0631

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

1465 Kelly Johnson Blvd
Suite 220
Colorado Springs, CO 80920-3955

Mailing address

5605 Coachwood TRL
Colorado Springs, CO 80919-4454
Phone (719) 598-0631

Other identifiers 1

IdentifierTypeStateIssuer
85487210MedicaidCO

Other names 1

  • Sunrise Pediatrics 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
06D1098870Pamela W Casson, MD PC1465 Kelly Johnson Blvd #220, Colorado Springs, CO 80920Certificate of waiverApr 28, 2027

National Provider Directory

National Provider Directory

Locations

1465 Kelly Johnson Blvd
Ste 220
Colorado Springs, CO 80920
Phone (719) 265-1050

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": "1237420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237420800000",
    "number": "1477794428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5605 COACHWOOD TRL",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809194454",
            "telephone_number": "719-598-0631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 KELLY JOHNSON BLVD",
            "address_2": "SUITE 220",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809203955",
            "telephone_number": "719-265-1050",
            "fax_number": "719-265-2503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAMELA W. CASSON, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-19",
        "last_updated": "2009-03-19",
        "status": "A",
        "authorized_official_last_name": "CASSON",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "WALLACE",
        "authorized_official_title_or_position": "PEDIATRICIAN",
        "authorized_official_telephone_number": "719-598-0631",
        "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": "85487210",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sunrise Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 19, 2009; 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.