NPIMap

Organization Active NPI

Mountainland Pediatrics Inc

  • Pediatrics Physician
  • Thornton, CO
National Provider Identifier
1619152576
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25750 Issued in CO
Legal business name
MOUNTAINLAND PEDIATRICS INC
Practice address
8889 Fox Dr
Suite a
Thornton, CO 80260-8841
Phone
(303) 430-0823
Fax
(303) 426-9581
NPI assigned
Jan 9, 2008
Last updated
Jul 1, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY REACH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Authorized official

Name
Mr. Richard Doucet
Title
Chief Executive Office
Phone
(303) 853-3500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25750 CO Primary

Addresses

Primary practice location

8889 Fox Dr
Suite a
Thornton, CO 80260-8841

Mailing address

1870 W 122ND Ave Ste 100
Westminster, CO 80234-2075
Phone (303) 853-3500

National Provider Directory

National Provider Directory
Tax ID family
Mountainland Pediatrics Inc2 organizations share this tax ID, including this one
Part of
Community Reach Center

Other organizations with this tax ID 1

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

Locations

8889 Fox Dr
Ste A
Thornton, CO 80260
Phone (303) 430-0823

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": "1199836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719792000000",
    "number": "1619152576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1870 W 122ND AVE STE 100",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "802342075",
            "telephone_number": "303-853-3500",
            "fax_number": "303-426-9340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8889 FOX DR",
            "address_2": "SUITE A",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802608841",
            "telephone_number": "303-430-0823",
            "fax_number": "303-426-9581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAINLAND PEDIATRICS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY REACH CENTER",
        "enumeration_date": "2008-01-09",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A",
        "authorized_official_last_name": "DOUCET",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICE",
        "authorized_official_telephone_number": "303-853-3500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "25750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thornton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; 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.