Individual provider Active NPI

Calvin G Staub, CPED

  • Pedorthist
  • Golden, CO
National Provider Identifier
1740935808
Registry record updated Feb 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PedorthistTaxonomy code 224L00000X
License
000835511L Issued in CO
Practice address
710 Golden Ridge Rd Ste 112
Golden, CO 80401-9566
Phone
(303) 567-4854
Fax
(303) 567-0291
NPI assigned
Feb 17, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pedorthist 224L00000X 000835511L CO Primary

Addresses

Primary practice location

710 Golden Ridge Rd Ste 112
Golden, CO 80401-9566

Mailing address

710 Golden Ridge Rd Ste 112
Golden, CO 80401-9566
Phone (303) 567-4854

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
000835511LCOMDPedorthist

NPI Registry JSON

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

{
    "created_epoch": "1645056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645056000000",
    "number": "1740935808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 GOLDEN RIDGE RD STE 112",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804019566",
            "telephone_number": "303-567-4854",
            "fax_number": "303-567-0291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 GOLDEN RIDGE RD STE 112",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804019566",
            "telephone_number": "303-567-4854",
            "fax_number": "303-567-0291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAUB",
        "first_name": "CALVIN",
        "middle_name": "G",
        "credential": "CPED",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-17",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224L00000X",
            "taxonomy_group": "",
            "desc": "Pedorthist",
            "state": "CO",
            "license": "000835511L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Golden, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2022; 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.