Active NPI
Catholic Health Initiatives Colorado
- Pediatrics Physician
- Canon City, CO
National Provider Identifier
1992114334
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- Legal business name
- CATHOLIC HEALTH INITIATIVES COLORADO
- Practice address
- 1335 Phay Ave
Suite a
Canon City, CO 81212-2334 - Phone
- (719) 285-2091
- Fax
- (719) 285-2092
- NPI assigned
- Aug 11, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Angela Skinner
- Title
- Administrator Oma
- Phone
- (303) 673-7175
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | Primary |
Addresses
Primary practice location
1335 Phay Ave
Suite a
Canon City, CO 81212-2334
Mailing address
PO Box 911057
Denver, CO 80291-1057
Phone (303) 643-1099
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 55906257 | Medicaid | CO |
Other names 1
- Centura Health Physician Group St Thomas More Pediatric Health Svcs
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031215000462 | CO | Part B Supplier - Clinic/Group Practice | 8022927342 |
Receives reassigned benefits from 1,310 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Pueblo, CO
- NPI 1609162353
-
- Hospitalist Physician
- Colorado Springs, CO
- NPI 1811963226
-
- Family Nurse Practitioner
- Woodland Park, CO
- NPI 1710011689
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407715200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1461110400000",
"number": "1992114334",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 911057",
"city": "DENVER",
"state": "CO",
"postal_code": "802911057",
"telephone_number": "303-643-1099",
"fax_number": "303-643-1176"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1335 PHAY AVE",
"address_2": "SUITE A",
"city": "CANON CITY",
"state": "CO",
"postal_code": "812122334",
"telephone_number": "719-285-2091",
"fax_number": "719-285-2092"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CATHOLIC HEALTH INITIATIVES COLORADO",
"organizational_subpart": "NO",
"enumeration_date": "2014-08-11",
"last_updated": "2016-04-20",
"status": "A",
"authorized_official_last_name": "SKINNER",
"authorized_official_first_name": "ANGELA",
"authorized_official_title_or_position": "ADMINISTRATOR OMA",
"authorized_official_telephone_number": "303-673-7175"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pediatrics",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "55906257",
"state": "CO"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Centura Health Physician Group St Thomas More Pediatric Health Svcs",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Canon City, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.