Sprouts Psychiatry

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Legal business name

SPROUTS PSYCHIATRY

Practice address

561 W 173Rd PL
Broomfield, CO 80023-5202

Phone

(860) 961-8406

NPI assigned

Jun 17, 2024

Organization subpart

No

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

Authorized official

Name

Sage Thibdeau, PA-CNPI 1801087424

Title

Psychiatric PA

Phone

(720) 618-7098

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sage Elizabeth Thibdeau, PA

  • Physician Assistant
  • Erie, CO
  • NPI 1801087424
  NPD Authorized official

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

{
    "created_epoch": "1718582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727568000000",
    "number": "1962245126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "561 W 173RD PL",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800235202",
            "telephone_number": "860-961-8406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "561 W 173RD PL",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800235202",
            "telephone_number": "860-961-8406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPROUTS PSYCHIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-17",
        "last_updated": "2024-09-29",
        "certification_date": "2024-09-29",
        "status": "A",
        "authorized_official_last_name": "THIBDEAU",
        "authorized_official_first_name": "SAGE",
        "authorized_official_title_or_position": "PSYCHIATRIC PA",
        "authorized_official_telephone_number": "720-618-7098",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Lynn Spicer, OTR
• Jordan Spiering, OTR
• Courtney Ann Spivey, PT
• Katherine Q Spooner, MSSW, LCSW
• Paul Victor Springer, PA-C
• M Nabi Sroosh, MASTERS
• Jenny St. Claire, MA, LPCC
• Grace Ann Staehlin, FNP
• Dana Stanek
• Martha Stangoni, RN, MSN

• Physician Assistant in Broomfield, CO
• Providers in Broomfield, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 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.