MEDICARE: ST. CHARBEL HEALTH, PLLC

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	207RR0500X	Rheumatology Physician

General Provider Information

NPI Number	:	1689537888
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ST. CHARBEL HEALTH, PLLC

Provider Business Mailing Address
First Line	:	2459 S CHASE LN
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80227-3902
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3601 S PENNSYLVANIA ST STE B
Second Line	:
City	:	ENGLEWOOD
State	:	CO
Zip	:	80113-3753
Country	:	US
Telephone Number	:	720-262-2462
Fax Number	:	720-330-5765

Authorized Official
Title or Position	:	CEO
Name	:	SUSAN BOACKLE CHILDRESS
Credential	:	MD
Telephone Number	:	720-262-2462

Provider Enumeration Date	:	12/04/2025
Last Update Date	:	02/13/2026

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