NPIMap

Organization Active NPI

Kremmling Memorial Hospital District

Doing business as Middle Park Medical Center

  • Family Medicine Physician
  • Granby, CO
National Provider Identifier
1548066178
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
KREMMLING MEMORIAL HOSPITAL DISTRICT
Doing business as
Middle Park Medical Center
Practice address
1000 Granby Park Dr S
Granby, CO 80446-5304
Phone
(970) 724-3442
Fax
(970) 724-9606
NPI assigned
Feb 24, 2025
Last updated
Feb 24, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
KREMMLING MEMORIAL HOSPITAL DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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

Authorized official

Name
Jason Marshall Cleckler
Title
Ceo
Phone
(970) 208-2907

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1000 Granby Park Dr S
Granby, CO 80446-5304

Mailing address

PO Box 399
Kremmling, CO 80459-0399
Phone (970) 724-3442

Other names 1

  • Middle Park Medical Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kremmling Memorial Hospital17 organizations share this tax ID, including this one
Part of
Kremmling Memorial Hospital

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1740355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740355200000",
    "number": "1548066178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 399",
            "city": "KREMMLING",
            "state": "CO",
            "postal_code": "804590399",
            "telephone_number": "970-724-3442",
            "fax_number": "970-724-9606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 GRANBY PARK DR S",
            "city": "GRANBY",
            "state": "CO",
            "postal_code": "804465304",
            "telephone_number": "970-724-3442",
            "fax_number": "970-724-9606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KREMMLING MEMORIAL HOSPITAL DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KREMMLING MEMORIAL HOSPITAL DISTRICT",
        "enumeration_date": "2025-02-24",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A",
        "authorized_official_last_name": "CLECKLER",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "MARSHALL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "970-208-2907"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Middle Park Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Granby, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; 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.