MAINSTREET PEDIATRICS (NPI# 1720511058) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720511058 |
| Entity Type | Organization |
| Organization Name | MAINSTREET PEDIATRICS |
| Practice Address |
9235 Crown Crest Blvd Suite 100 Parker CO 80138-8880 |
| Practice Telephone | 7204586543 |
| Practice Fax Number | 7204586544 |
| Mailing Telephone | 7204586543 |
| Mailing Fax Number | 7204586544 |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2017-04-04 |
| Authorized Official Name | LORRI M. PHIPPS (OWNER) |
| Authorized Official Telephone | 7204586543 |
| Authorized Official Credential | DNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | APN.0010267-NP | CO | Allopathic & Osteopathic Physicians |
| Street Address |
9235 CROWN CREST BLVD SUITE 100 |
| City | PARKER |
| State | CO |
| Zip Code | 80138-8880 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013999895 | Ravi C Shah | Psychiatry & Neurology | 9235 Crown Crest Blvd, Suite 200, Parker, CO 80138-8880 | 2005-11-16 |
| 1013440726 | Andrea Crandall | Nurse Practitioner | 9235 Crown Crest Blvd, Suite 100, Parker, CO 80138-8880 | 2017-04-10 |
| 1043633647 | Pediatric and Adolescent Medicine Associates PC | Clinic/Center | 9235 Crown Crest Blvd, Suite 100, Parker, CO 80138-8880 | 2014-02-03 |
| 1659632040 | Jaime Lynn Fell | Physician Assistant | 9235 Crown Crest Blvd, 100, Parker, CO 80138-8880 | 2012-06-02 |
| 1801119383 | Janae Ila Haycock | Nurse Practitioner | 9235 Crown Crest Blvd, Suite 100, Parker, CO 80138-8880 | 2010-03-11 |
| 1861635666 | Sarah Elizabeth Smith | Physician Assistant | 9235 Crown Crest Blvd, Suite 200, Parker, CO 80138-8880 | 2009-04-09 |
| 1124276688 | Rocky Mountain Fertility Lab | Clinical Medical Laboratory | 9235 Crown Crest Blvd, Suite 250, Parker, CO 80138 | 2008-09-08 |
| 1457518680 | Jeffrey K Tamsing | Psychiatry & Neurology | 9235 Crown Crest Blvd, Suite 200, Parker, CO 80138-8880 | 2008-05-16 |
| 1457557191 | Kathryn Ann Polovitz | Internal Medicine | 9235 Crown Crest Blvd, Suite 200, Parker, CO 80138-8880 | 2007-06-21 |
| 1538280466 | Neurology of The Rockies, LLC | Psychiatry & Neurology | 9235 Crown Crest Blvd, Suite 200, Parker, CO 80138-8880 | 2007-04-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306443718 | Douglas County Christian Counseling Inc. | Counselor | 9030 Miller Road, Parker, CO 80138 | 2020-10-08 |
| 1568081198 | Dr. Trathen & Associates, PC | Clinic/Center | 19284 Cottonwood Dr., Suite 202, Parker, CO 80138 | 2020-04-14 |
| 1427601228 | Mendalyn Berry | Counselor | 19751 Mainstreet, Suite 395, Parker, CO 80138 | 2019-07-20 |
| 1366925349 | Deborah Kolker Mastin | Social Worker | 19753 E. Pikes Peak Ave, Parker, CO 80138 | 2018-09-14 |
| 1861988131 | Premere Rehab LLC | Occupational Therapist | 19160 Cottonwood Dr, Parker, CO 80138 | 2018-07-10 |
| 1043737315 | Ponderosa Counseling Center LLC | Nurse Practitioner | 19753 E Pikes Peak Ave, Suite 202, Parker, CO 80138 | 2017-08-27 |
| 1942674502 | Brittany Caitlin Peters | Occupational Therapist | 12169 S Hidden Trail Ct, Parker, CO 80138 | 2015-11-19 |
| 1548650799 | Robyn Looze | Social Worker | 19563 East Mainstreet Suite, 204, Parker, CO 80138 | 2015-01-27 |
| 1013328426 | Dena Dobbs | Dietitian, Registered | 9397 Crown Crest Blvd, Suite 440, Parker, CO 80138 | 2014-05-20 |
| 1811322092 | Aba At Legacy | Behavioral Analyst | 19751 E. Mainstreet Ste. 215, Parker, CO 80138 | 2013-09-06 |
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| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316020761 | Brian Burt Stanga | Pediatrics | 10371 Park Glenn Way, Parker, CO 80138 | 2006-10-21 |
| 1699735274 | Nancy J Mcdermott | Pediatrics | 9397 Crown Crest Blvd Ste 330, Parker, CO 80138-8788 | 2006-03-27 |
| 1376510495 | Alice D. Calhoun | Pediatrics | 12033 Agency Rd, Parker, AZ 85344-7718 | 2006-03-07 |
| 1437756715 | Aurora Pediatric Associates, LLP | Pediatrics | 9397 Crown Crest Blvd Ste 330, Parker, CO 80138-8788 | 2020-10-08 |
| 1255955647 | Obstetrix Medical Group of Colorado, P.C. | Pediatrics | 9395 Crown Crest Blvd, Parker, CO 80138-8573 | 2020-06-02 |
| 1376912865 | Pinnacle Medical Partners LLC | Pediatrics | 9397 Crown Crest Blvd, Suite 211, Parker, CO 80138-8575 | 2015-09-15 |
| 1497021679 | Tequa Med-peds LLC | Pediatrics | 601 W Riverside Dr, Parker, AZ 85344-5119 | 2012-04-01 |
| 1013142363 | Portercare Adventist Health System | Pediatrics | 9399 Crown Crest Blvd, Suite 200, Parker, CO 80138 | 2009-05-15 |
| 1932364072 | Olukemi P Akinrinola | Pediatrics | 10371 Parkglenn Way, Ste 220, Parker, CO 80138-3885 | 2008-07-28 |
| 1144408154 | Jill S Weiner | Pediatrics | 9397 Crown Crest Blvd, Suite 211, Parker, CO 80138-8575 | 2008-02-01 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.