The Pediatric Center, Professional LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0049882 Issued in CO

Legal business name

THE PEDIATRIC CENTER, PROFESSIONAL LLC

Practice address

4745 Arapahoe Ave
Suite 310
Boulder, CO 80303-1080

Phone

(303) 442-2913

Fax

(303) 444-6198

NPI assigned

Sep 8, 2014

Last updated

Sep 8, 2014By 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

Daniel Sarko, MDNPI 1073586525

Title

Partner

Phone

(303) 442-2913

Specialties & licenses 1

Addresses

Practitioners 4

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.

• Daniel Robert Sarko, MD

  • Pediatrics Physician
  • Baltimore, MD
  • NPI 1073586525
  NPD (past) Authorized official
• Jill Kamon, M.D.

  • Pediatrics Physician
  • Boulder, CO
  • NPI 1831101773
  NPD (past)
• Ellen McCormack, MD

  • Pediatrics Physician
  • Denver, CO
  • NPI 1811423569
  NPD (past)
• Megan Kathleen Woodward, M.D.

  • Pediatrics Physician
  • Smyrna, TN
  • NPI 1235572777
  NPD (past)

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

{
    "created_epoch": "1410134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410134400000",
    "number": "1497156509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4745 ARAPAHOE AVE",
            "address_2": "SUITE 310",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803031080",
            "telephone_number": "303-442-2913",
            "fax_number": "303-444-6198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4745 ARAPAHOE AVE",
            "address_2": "SUITE 310",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803031080",
            "telephone_number": "303-442-2913",
            "fax_number": "303-444-6198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PEDIATRIC CENTER, PROFESSIONAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-08",
        "last_updated": "2014-09-08",
        "status": "A",
        "authorized_official_last_name": "SARKO",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "303-442-2913",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "0049882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Mind Embodied PC
• The Other Road Counseling PLLC
• The Other Road Counseling PLLC
• The Other Road Counseling PLLC
• The Other Therapy Online, LLC
• The Postpartum Wellness Center of Boulder (Parent and Family Wellness Center)
• The Pure Life Center, LLC
• The Thermogram Center, Inc.
• Wendy L Theall, CMT, B.A.
• Molly Anne Thelosen, BA

• Pediatrics Physician in Boulder, CO
• Providers in Boulder, CO by specialty
• Pediatrics Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2014; 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.