NPIMap

Organization Active NPI

Ccpartners LLC

Doing business as Kidz Biz Pediatrics

  • Pediatric Adolescent Medicine Physician
  • Festus, MO
National Provider Identifier
1487857033
Registry record updated Feb 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
Legal business name
CCPARTNERS LLC
Doing business as
Kidz Biz Pediatrics
Practice address
35 Goodwin Dr
Festus, MO 63028-4122
Phone
(636) 933-4141
Fax
(636) 931-7007
NPI assigned
Jun 8, 2007
Last updated
Feb 7, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2014

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

Authorized official

Name
Joshua Paul Boldt, MDNPI 1013992189
Title
Physician/Partner
Phone
(636) 933-4141

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 Adolescent Medicine Physician 2080A0000X NU Primary

Addresses

Primary practice location

35 Goodwin Dr
Festus, MO 63028-4122

Mailing address

35 Goodwin Dr
Festus, MO 63028-4122
Phone (636) 933-4141

Other identifiers 4

IdentifierTypeStateIssuer
36393OtherMOHEALTHCARE USA
100301OtherMOGROUP HEALTH PLAN
507593903MedicaidMO
0191OtherMOMERCY CARE PLUS

Other names 1

  • Kidz Biz 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
26D0685556Kidz Biz Pediatrics35 Goodwin Drive, Festus, MO 63028Certificate of waiverAug 29, 2026

National Provider Directory

National Provider Directory

Locations

35 Goodwin Dr
Crystal Cty, MO 63028
Phone (636) 933-4141

1309 Maple St
Farmington, MO 63640
Phone 5737564343 ext. 22010

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1181260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391731200000",
    "number": "1487857033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 GOODWIN DR",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630284122",
            "telephone_number": "636-933-4141",
            "fax_number": "636-931-7007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 GOODWIN DR",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630284122",
            "telephone_number": "636-933-4141",
            "fax_number": "636-931-7007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCPARTNERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-08",
        "last_updated": "2014-02-07",
        "status": "A",
        "authorized_official_last_name": "BOLDT",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "PHYSICIAN/PARTNER",
        "authorized_official_telephone_number": "636-933-4141",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHCARE USA",
            "identifier": "36393",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH PLAN",
            "identifier": "100301",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "507593903",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY CARE PLUS",
            "identifier": "0191",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kidz Biz Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Festus, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2014; 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.