Organization Active NPI

Catholic Health Initiatives Colorado

  • Pediatrics Physician
  • Canon City, CO
National Provider Identifier
1992114334
Registry record updated Apr 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
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

Updated by the provider on Apr 20, 2016

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)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 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

IdentifierTypeStateIssuer
55906257MedicaidCO

Other names 1

  • Centura Health Physician Group St Thomas More Pediatric Health Svcs Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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 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.

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.

Verify at the official NPI Registry.