NPIMap

Organization Active NPI

Centennial Pediatrics, PC

  • Pediatrics Physician
  • Centennial, CO
National Provider Identifier
1972773612
Registry record updated Mar 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
38052 Issued in CO
Legal business name
CENTENNIAL PEDIATRICS, PC
Practice address
15464 E. Orchard Road
Centennial, CO 80016
Phone
(303) 680-5437
NPI assigned
Mar 10, 2008
Last updated
Mar 10, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2008

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

Authorized official

Name
Dr. Michelle Kuntz Stanford, MDNPI 1952368904
Title
Physician
Phone
(303) 680-5437

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 38052 CO Primary

Addresses

Primary practice location

15464 E. Orchard Road
Centennial, CO 80016

Mailing address

15464 E. Orchard Road
Centennial, CO 80016
Phone (303) 680-5437

Other identifiers 1

IdentifierTypeStateIssuer
29303559MedicaidCO

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
06D1025276Centennial Pediatrics, PC15464 East Orchard Road, Centennial, CO 80016Provider-performed microscopyMay 3, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

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": "1205107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205107200000",
    "number": "1972773612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15464 E. ORCHARD ROAD",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "80016",
            "telephone_number": "303-680-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15464 E. ORCHARD ROAD",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "80016",
            "telephone_number": "303-680-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTENNIAL PEDIATRICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-10",
        "last_updated": "2008-03-10",
        "status": "A",
        "authorized_official_last_name": "STANFORD",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "KUNTZ",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "303-680-5437",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "38052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "29303559",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Centennial, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2008; 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.