THE LITTLE CLINIC OF COLORADO LLC (NPI# 1518564319) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518564319 |
| Entity Type | Organization |
| Organization Name | THE LITTLE CLINIC OF COLORADO LLC |
| Practice Address |
2355 W 136th Ave Broomfield CO 80023-9331 |
| Mailing Address |
Po Box 932958 Cleveland OH 44193-0028 |
| Practice Telephone | 3036589827 |
| Enumeration Date | 2020-10-05 |
| Last Update Date | 2020-10-05 |
| Authorized Official Name | MARC ROBERT WATKINS (CMO) |
| Authorized Official Telephone | 6154254221 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 9000165173 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093312498 | The Little Clinic of Colorado LLC | Physician Assistant | 12959 S Parker Rd, Parker, CO 80134-3447 | 2020-10-08 |
| 1588261374 | The Little Clinic of Colorado LLC | Physician Assistant | 17761 Cottonwood Dr, Parker, CO 80134-3925 | 2020-10-05 |
| 1023615820 | The Little Clinic of Colorado LLC | Physician Assistant | 3100 S Sheridan Blvd, Denver, CO 80227-5541 | 2020-10-05 |
| 1275130072 | The Little Clinic of Colorado LLC | Physician Assistant | 1750 W Uintah St, Colorado Springs, CO 80904-2926 | 2020-10-05 |
| 1538766340 | The Little Clinic of Colorado LLC | Physician Assistant | 5544 Promenade Pkwy, Castle Rock, CO 80108-1903 | 2020-10-05 |
| 1700483500 | The Little Clinic of Colorado LLC | Physician Assistant | 12167 Sheridan Blvd, Broomfield, CO 80020-2417 | 2020-10-05 |
| 1598362394 | The Little Clinic of Colorado LLC | Physician Assistant | 2100 35th Ave, Greeley, CO 80634-3910 | 2020-10-05 |
| 1043817844 | The Little Clinic of Colorado LLC | Physician Assistant | 3620 Austin Bluffs Pkwy, Colorado Springs, CO 80918-6631 | 2020-10-05 |
| 1861099673 | The Little Clinic of Colorado LLC | Physician Assistant | 2810 Quebec St, Denver, CO 80207-2900 | 2020-10-05 |
| 1679170484 | The Little Clinic of Colorado LLC | Physician Assistant | 1842 N College Ave, Fort Collins, CO 80524-1323 | 2020-10-05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | The Little Clinic of Colorado LLC | 1014 Vine Street, Cincinnati, OH 45202 |
| Street Address |
2355 W 136TH AVE |
| City | BROOMFIELD |
| State | CO |
| Zip Code | 80023-9331 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134115546 | Audrey Jo Haimes | Nurse Practitioner | 2355 W 136th Ave, Broomfield, CO 80023-9331 | 2005-09-21 |
| 1386244127 | Michelle Rose Scotto | Nurse Practitioner | 2355 W 136th Ave, Broomfield, CO 80023-9331 | 2020-10-30 |
| 1164991238 | Grace Ann Staehlin | Nurse Practitioner | 2355 W 136th Ave, Broomfield, CO 80023-9331 | 2018-11-19 |
| 1326470733 | Eric W Liang | Pharmacist | 2355 W 136th Ave, Broomfield, CO 80023-9331 | 2013-08-07 |
| 1326488404 | Donna Huckaby | Pharmacist | 2355 W 136th Ave, Broomfield, CO 80023-9331 | 2013-07-03 |
| 1578903712 | Margaret Angel Underwood | Pharmacist | 2355 W 136th Ave, Broomfield, CO 80023-9331 | 2013-07-02 |
| 1144463076 | Dillon Companies LLC | Pharmacy | 2355 W 136th Ave, Broomfield, CO 80023 | 2009-04-08 |
| 1740321405 | Elizabeth Ann Boling Langer | Nurse Practitioner | 2355 W 136th Ave, Broomfield, CO 80023-9331 | 2007-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730793803 | Alexis Marie Gerry | Dentist | 13606 Xavier Lane Suite B, Broomfield, CO 80023 | 2020-09-04 |
| 1023646973 | Jonathan Michael Dill | Student in an Organized Health Care Education/Training Program | 14300 Orchard Parkway - 1st Floor, Westminster, CO 80023 | 2020-03-27 |
| 1821624594 | Kelley Stephenson | Social Worker | 469 Co-7, Broomfield, CO 80023 | 2020-03-13 |
| 1205482031 | Visionary Eye Care, Pllc | Optometrist | 16860 Sheridan Parkway, Unit 106, Broomfield, CO 80023 | 2019-08-16 |
| 1104387810 | Daniel Ojala | Student in an Organized Health Care Education/Training Program | 14300 Orchard Pkwy, 1 St Floor, Westminster, CO 80023 | 2019-03-26 |
| 1184102527 | Kristina Elizabeth Rainwater | Occupational Therapist | 3303 W 144th Ave #207, Broomfield, CO 80023 | 2018-07-28 |
| 1689122467 | Jane Vela | Physical Therapist | 14866 Falcon Drive, Broomfield, CO 80023 | 2016-09-21 |
| 1134573850 | Hanger Prosthetics & Orthotics, Inc. | Durable Medical Equipment & Medical Supplies | 500 W 144th Ave Ste 200, Westminster, CO 80023 | 2016-04-19 |
| 1235541426 | Hearthside Dentistry | Dentist | 16578 N Washington St, Thornton, CO 80023 | 2014-05-22 |
| 1295168698 | Christina O Mcmillon Dentistry, Pllc | Dentist | 16578 North Washington St, Thornton, CO 80023 | 2013-08-21 |
| Find all providers in zip 80023 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407455157 | Faith Emma Olson | Nurse Practitioner | 2550 Winding River Dr Unit C1, Broomfield, CO 80023-6545 | 2020-10-23 |
| 1548869860 | Colleen R Newvine | Nurse Practitioner | 2831 W 133rd Ave, Broomfield, CO 80020-5263 | 2020-10-19 |
| 1508480724 | Colton Grant Miller | Nurse Practitioner | 14531 Prairie Sky Ln, Broomfield, CO 80023-8771 | 2020-06-03 |
| 1487276507 | Marie Louise Richardson | Nurse Practitioner | 3101 Hourglass Pl, Broomfield, CO 80023-8025 | 2020-05-12 |
| 1447893110 | Stephanie Lynn Kipp | Nurse Practitioner | 5023 W 120th Ave # 312, Broomfield, CO 80020-5606 | 2019-10-24 |
| 1366998734 | Lisa Shaheen | Nurse Practitioner | 4644 Winona Pl, Broomfield, CO 80020-5647 | 2016-08-26 |
| 1972919421 | Melissa Ginsburg | Nurse Practitioner | 12516 Whippoorwill St, Broomfield, CO 80020-7918 | 2014-07-04 |
| 1689013377 | Catherine Encinias Felson | Nurse Practitioner | 3111 W 127th Ave, Broomfield, CO 80020-5811 | 2013-06-17 |
| 1780907147 | Kelly Pauline Krieger | Nurse Practitioner | 11935 Quay St, Broomfield, CO 80020-2816 | 2010-03-12 |
| 1619160454 | Kristin Carolyn Bradley | Nurse Practitioner | 2555 W Midway Blvd, Broomfield, CO 80020-1632 | 2007-08-24 |
| Find all providers in BROOMFIELD | ||||
| City | BROOMFIELD |
| Zip Code | 80023 |
Please comment or provide details below to improve the information on THE LITTLE CLINIC OF COLORADO LLC.
| 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.