Rocky Mountain Pediatric Gastroenterology

Primary specialty

Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X

Legal business name

ROCKY MOUNTAIN PEDIATRIC GASTROENTEROLOGY

Practice address

10465 Park Meadows Dr Ste 201
Lone Tree, CO 80124-5321

Phone

(303) 790-1515

Fax

(303) 790-1989

NPI assigned

Mar 30, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Theodore H. Stathos, MD

Title

Authorized Official, President

Phone

(303) 790-1515

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553731200000",
    "number": "1699895755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10465 PARK MEADOWS DR STE 201",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801245321",
            "telephone_number": "303-790-1515",
            "fax_number": "303-790-1989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10465 PARK MEADOWS DR STE 201",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801245321",
            "telephone_number": "303-790-1515",
            "fax_number": "303-790-1989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKY MOUNTAIN PEDIATRIC GASTROENTEROLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2019-03-28",
        "status": "A",
        "authorized_official_last_name": "STATHOS",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL, PRESIDENT",
        "authorized_official_telephone_number": "303-790-1515",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04018362",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rocky Mountain Infectious Disease Specialists, P.C.
• Rocky Mountain Kidney Care LLC
• Rocky Mountain Monitoring and Assist, LLC
• Rocky Mountain Neurosurgery, P.C.
• Rocky Mountain Oral & Maxillofacial Surgery, Prof LLC
• Rocky Mountain Pediatric Urology, PC
• Rocky Mountain Physicians Group, PC
• Rocky Mountain Sleep Center LLC
• Rocky Mountain Spine & Sport, LLC
• Rocky Mountain Spine and Sport, LLC

• Pediatric Gastroenterology Physician in Lone Tree, CO
• Providers in Lone Tree, CO by specialty
• Pediatric Gastroenterology Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2019; 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.