Colorado Children's Medical Group, P.C.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

38062 Issued in CO

Legal business name

COLORADO CHILDREN'S MEDICAL GROUP, P.C.

Practice address

9397 Crown Crest Blvd
Suite 211
Parker, CO 80138-8575

Phone

(303) 369-6977

Fax

(303) 369-1909

NPI assigned

Apr 7, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jill Weiner, M.D.

Title

President

Phone

(303) 369-6977

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483401600000",
    "number": "1760445183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9397 CROWN CREST BLVD",
            "address_2": "SUITE 211",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801388575",
            "telephone_number": "303-369-6977",
            "fax_number": "303-369-1909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9397 CROWN CREST BLVD",
            "address_2": "SUITE 211",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801388575",
            "telephone_number": "303-369-6977",
            "fax_number": "303-369-1909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO CHILDREN'S MEDICAL GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-07",
        "last_updated": "2017-01-03",
        "status": "A",
        "authorized_official_last_name": "WEINER",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "303-369-6977",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "38062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "55003371",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "58985581",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Parker, CO
• Providers in Parker, CO by specialty
• Pediatrics Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2017; 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.