Organization Active NPI

Pediatrics at the Meadows, P.C.

  • Pediatrics Physician
  • Castle Rock, CO
National Provider Identifier
1851423024
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PEDIATRICS AT THE MEADOWS, P.C.
Practice address
3911 Ambrosia St Ste 100
Castle Rock, CO 80109-3887
Phone
(303) 688-5226
Fax
(303) 814-0717
NPI assigned
Mar 12, 2007
Last updated
Feb 28, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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

Authorized official

Name
Susan Clark
Title
Practice Manager
Phone
(303) 688-5226

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X Primary

Addresses

Primary practice location

3911 Ambrosia St Ste 100
Castle Rock, CO 80109-3887

Mailing address

3911 Ambrosia St Ste 100
Castle Rock, CO 80109-3887
Phone (303) 688-5226

Other identifiers 1

IdentifierTypeStateIssuer
98903314MedicaidCO

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D0511334Pediatrics at the Meadows3911 Ambrosia St, Suite 100, Castle Rock, CO 80109Certificate of waiverDec 21, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709078400000",
    "number": "1851423024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3911 AMBROSIA ST STE 100",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801093887",
            "telephone_number": "303-688-5226",
            "fax_number": "303-814-0717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3911 AMBROSIA ST STE 100",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801093887",
            "telephone_number": "303-688-5226",
            "fax_number": "303-814-0717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRICS AT THE MEADOWS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "303-688-5226"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "98903314",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Castle Rock, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2024; 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.