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1417162876

NPI Code Detail

MEDICARE: PEDIATRIC PARTNERS

MEDICARE: PEDIATRIC PARTNERS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417162876
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEDIATRIC PARTNERS

Provider Business Mailing Address
First Line	:	1905 BLAKE AVE STE 201
Second Line	:
City	:	GLENWOOD SPRINGS
State	:	CO
Zip	:	81601-4286
Country	:	US
Telephone Number	:	970-947-9999
Fax Number	:	970-947-9226

Provider Business Practice Location Address
First Line	:	1905 BLAKE AVE STE 201
Second Line	:
City	:	GLENWOOD SPRINGS
State	:	CO
Zip	:	81601-4286
Country	:	US
Telephone Number	:	970-947-9999
Fax Number	:	970-947-9226

Authorized Official
Title or Position	:	CFO
Name	:	BONITA L WASLI
Credential	:
Telephone Number	:	970-384-6605

Provider Enumeration Date	:	05/11/2007
Last Update Date	:	02/17/2017

Similar Medicare Providers

1689437063 — KAYLEE A PETERSON SWC
Practice Location Address:

1905 BLAKE AVE STE 201
GLENWOOD SPRINGS, CO
81601-4286

Practice Phone: 970-384-6728
Practice Fax: 970-947-9226

1235118498 — TERI GLEE STEVENSON MD
Practice Location Address:

1905 BLAKE AVE STE 201
GLENWOOD SPRINGS, CO
81601-4286

Practice Phone: 970-947-9999
Practice Fax:

1700173242 — HEATHER L GARDNER MD
Practice Location Address:

1905 BLAKE AVE STE 201
GLENWOOD SPRINGS, CO
81601-4286

Practice Phone: 970-947-9999
Practice Fax: 970-947-9226

1669890802 — CAITLIN HALL D.O
Practice Location Address:

1905 BLAKE AVE STE 201
GLENWOOD SPRINGS, CO
81601-4286

Practice Phone: 970-947-9999
Practice Fax: 970-947-9226

1578084513 — KELSEA WREN LOVELESS-HOFFMAN MD
Practice Location Address:

1905 BLAKE AVE STE 201
GLENWOOD SPRINGS, CO
81601-4286

Practice Phone: 970-947-9999
Practice Fax: 970-947-9226

1578041323 — JACQUELINE WEAST LCSW
Practice Location Address:

1905 BLAKE AVE STE 201
GLENWOOD SPRINGS, CO
81601-4286

Practice Phone: 970-947-9999
Practice Fax: 970-947-9226

Directions to “PEDIATRIC PARTNERS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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