| Integrative Pediatric Health Care, Llc | |
|
3540 S Poplar St Ste 202 Denver CO 80237-1362 | |
| (720) 442-3615 | |
| (720) 870-3726 |
| Full Name | Integrative Pediatric Health Care, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3540 S Poplar St Ste 202, Denver, Colorado |
| Authorized Official Name and Position | Jennifer Gaughan (MEMBER, PRACTITIONER) |
| Authorized Official Contact | 7194945123 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrative Pediatric Health Care, Llc 3540 S Poplar St Ste 202 Denver CO 80237-1362 Ph: (720) 442-3615 | Integrative Pediatric Health Care, Llc 3540 S Poplar St Ste 202 Denver CO 80237-1362 Ph: (720) 442-3615 |
| NPI Number | 1902275712 |
|---|---|
| Provider Enumeration Date | 09/22/2015 |
| Last Update Date | 02/03/2021 |
| Medicare PECOS PAC ID | 7719285469 |
|---|---|
| Medicare Enrollment ID | O20160412002514 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902275712 | NPI | - | NPPES |
| 10820051 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| 363LP0200X | Nurse Practitioner - Pediatrics | (* (Not Available)) | Secondary |
| Provider Name | Clare Huber-navin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386785913 PECOS PAC ID: 9931407681 Enrollment ID: I20160418000474 |
| Provider Name | Jennifer J Gaughan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700201589 PECOS PAC ID: 4789982430 Enrollment ID: I20160419000382 |
| Provider Name | Kelly E Reagan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831677343 PECOS PAC ID: 7618229766 Enrollment ID: I20190621000735 |
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