Lil Buckaroo Pediatrics

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

LIL BUCKAROO PEDIATRICS

Practice address

402 W US Highway 50
Fowler, CO 81039-9752

Phone

(719) 253-2555

NPI assigned

Jun 26, 2024

Last updated

Jun 26, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Stephanie Salbato, CPNPNPI 1639416555

Title

Pediatric Nurse Practitioner

Phone

(719) 253-2555

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Stephanie L Salbato, PNP

  • Pediatric Nurse Practitioner
  • Pueblo, CO
  • NPI 1639416555
  NPD Authorized official

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

{
    "created_epoch": "1719360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719360000000",
    "number": "1780429472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65200 STROUD RD",
            "city": "BOONE",
            "state": "CO",
            "postal_code": "810259617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 W US HIGHWAY 50",
            "city": "FOWLER",
            "state": "CO",
            "postal_code": "810399752",
            "telephone_number": "719-253-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIL BUCKAROO PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-26",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A",
        "authorized_official_last_name": "SALBATO",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "PEDIATRIC NURSE PRACTITIONER",
        "authorized_official_telephone_number": "719-253-2555",
        "authorized_official_credential": "CPNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alina Jolene Davis, RN
• Kassidy Fleming-Bankston, CCC-SLP
• Fowler Health Care Center, Inc.
• Fowler Rural Fire Protection District
• Suzanne Perez Heckmann
• Cami Manchego
• Robert B Moorhead
• Gordon Ray
• Tri County Housing & CDC
• David L Walters, DO

• Primary Care Clinic/Center in Fowler, CO
• Providers in Fowler, CO by specialty
• Primary Care Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.