THE LITTLE CLINIC OF COLORADO LLC (NPI# 1700483500) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700483500 |
| Entity Type | Organization |
| Organization Name | THE LITTLE CLINIC OF COLORADO LLC |
| Practice Address |
12167 Sheridan Blvd Broomfield CO 80020-2417 |
| Mailing Address |
Po Box 932958 Cleveland OH 44193-0028 |
| Practice Telephone | 3036579807 |
| 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 | 9000165165 | 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 |
| 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 |
| 1821695636 | The Little Clinic of Colorado LLC | Physician Assistant | 1891 State Highway 7, Erie, CO 80516-8003 | 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 |
12167 SHERIDAN BLVD |
| City | BROOMFIELD |
| State | CO |
| Zip Code | 80020-2417 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871538793 | Dillon Companies LLC | Pharmacy | 12167 Sheridan Blvd, Broomfield, CO 80020 | 2006-06-17 |
| 1295143436 | David R Salmon | Pharmacist | 12167 Sheridan Blvd, Broomfield, CO 80020-2417 | 2014-07-31 |
| 1861838864 | Anh Tuyet Thi Nguyen | Pharmacist | 12167 Sheridan Blvd, Broomfield, CO 80020-2417 | 2013-05-16 |
| 1215370465 | Lien Kim Nguyen | Pharmacist | 12167 Sheridan Blvd, Broomfield, CO 80020-2417 | 2013-04-08 |
| 1669493383 | Elisabeth Fabrizio | Nurse Practitioner | 12167 Sheridan Blvd, Broomfield, CO 80020-2417 | 2006-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487210993 | Terri Lynn Rist | Day Training, Developmentally Disabled Services | 12161 Crabapple Street, Broomfield, CO 80020 | 2019-05-10 |
| 1063984409 | This Is Massage | Registered Nurse | 2625 W 133rd Circle Dr., Broomfield Co, CO 80020 | 2018-12-26 |
| 1588187678 | Jenny St. Claire | Counselor | 80 Garden Ctr Ste 140, Broomfield, CO 80020 | 2017-07-20 |
| 1649791880 | Brett T Nelson | Dentist | 340 East 1st Avenue, Suite 202, Broomfield, CO 80020 | 2017-06-28 |
| 1073033411 | Patrice S Lensmire Gauthier | Occupational Therapist | 12970 Sheridan Blvd, Broomfield, CO 80020 | 2017-06-27 |
| 1871047753 | Michelle L Fussnecker | Physician Assistant | 6450 W 120th Ave Unit A, Broomfield, CO 80020 | 2016-08-09 |
| 1588029565 | Courtney Miller | Marriage & Family Therapist | 26 Garden Center Suite 1, Broomfield, CO 80020 | 2015-12-17 |
| 1659742161 | Heather Scott | Physician Assistant | 340 E 1st Ave Ste 100, Broomfield, CO 80020 | 2015-10-09 |
| 1154701407 | Emily Arrington | Speech-Language Pathologist | 1790 W 6th Ave, Broomfield, CO 80020 | 2015-06-02 |
| 1376939884 | Retro Dental Group Broomfield | Dentist | 5105 120th Ave, Broomfield, CO 80020 | 2015-04-10 |
| Find all providers in zip 80020 | ||||
| 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 | 80020 |
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.