NPIMap

Organization Active NPI

Castle Valley Children's Clinic

  • Primary Care Clinic/Center
  • New Castle, CO
National Provider Identifier
1578766689
Registry record updated Jan 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
CASTLE VALLEY CHILDREN'S CLINIC
Practice address
820 Castle Valley Blvd
Suite #204
New Castle, CO 81647-9480
Phone
(970) 984-3333
Fax
(970) 984-0293
NPI assigned
Jun 6, 2007
Last updated
Jan 7, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2020

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

Authorized official

Name
Ms. Debbieanne Moeller, CPNPNPI 1902967755
Title
President
Phone
(970) 984-3333

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
Primary Care Clinic/Center 261QP2300X NU Primary

Addresses

Primary practice location

820 Castle Valley Blvd
Suite #204
New Castle, CO 81647-9480

Mailing address

820 Castle Valley Blvd
Suite #204
New Castle, CO 81647-9480
Phone (970) 984-3333

Other identifiers 2

IdentifierTypeStateIssuer
08189731MedicaidCO
57507732MedicaidCO

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
06D0955806Castle Valley Children Clinic820 Castle Valley Blvd #204, New Castle, CO 81647Certificate of waiverJan 10, 2027

National Provider Directory

National Provider Directory
Tax ID family
Castle Valley Children's Clinic3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

Practitioners 5

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": "1181088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578355200000",
    "number": "1578766689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 CASTLE VALLEY BLVD",
            "address_2": "SUITE #204",
            "city": "NEW CASTLE",
            "state": "CO",
            "postal_code": "816479480",
            "telephone_number": "970-984-3333",
            "fax_number": "970-984-0293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 CASTLE VALLEY BLVD",
            "address_2": "SUITE #204",
            "city": "NEW CASTLE",
            "state": "CO",
            "postal_code": "816479480",
            "telephone_number": "970-984-3333",
            "fax_number": "970-984-0293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASTLE VALLEY CHILDREN'S CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-06",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A",
        "authorized_official_last_name": "MOELLER",
        "authorized_official_first_name": "DEBBIEANNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "970-984-3333",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CPNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08189731",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "57507732",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Castle, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2020; 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.