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NPI 1528718400ActiveIndividual· Pediatrics· Grand Junction, CO
Pediatrics in Grand Junction, Colorado, licensed in CO, with an NPI issued in March 2022. Enrolled in Medicare as practitioner - pediatric medicine.
Overview
| NPI | 1528718400 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Mar 24, 2022 |
| Last updated in NPPES | Sep 26, 2025 |
| Certified by provider | Sep 26, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pediatrics Primary | 208000000X | DR.0074940 | CO |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Pediatric Medicine (CO) |
|---|
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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All 42 pediatricians in Grand Junction · All pediatricians in Colorado