DBA MIDDLE PARK MEDICAL CENTER
NPI 1124456629
Clinic/Center - Rural Health in Granby, CO

Q: What is Kremmling Memorial Hospital District's NPI number?

The NPI number for Kremmling Memorial Hospital District is 1124456629. It was assigned to this organization in the NPPES registry on October 18, 2013. The provider is doing business as Dba Middle Park Medical Center.

Q: What is Kremmling Memorial Hospital District's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Active since October 18, 2013

1000 GRANBY PARK DRIVE SOUTH, GRANBY, CO 80446(970) 724-3442(970) 724-9606 Get Directions Write a Review

NPPES record last updated: March 18, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 31, 2021, Sep 8, 2020, Oct 28, 2016 (3 updates tracked since 2016).

On this page

About Dba Middle Park Medical Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DBA MIDDLE PARK MEDICAL CENTER (NPI 1124456629) is a healthcare organization registered as a rural health in Granby, Colorado and active in the NPI registry since October 2013. The organization lists Jason Marshall Cleckler, Ceo, as its authorized official.

NPPES Registry Identity

NPI1124456629

Entity TypeOrganization

Primary Taxonomy261QR1300X

Legal Business NameKREMMLING MEMORIAL HOSPITAL DISTRICT

Location Address1000 GRANBY PARK DRIVE SOUTHGranby, CO 80446-1169

Mailing AddressPo Box 399Kremmling, CO 80459-0399 · (970) 724-3442 · Fax (970) 724-9606

Phone(970) 724-3442

Fax(970) 724-9606

Organization SubpartYes

Authorized OfficialJason Marshall ClecklerCeo · (970) 208-2907

Enumeration DateOctober 18, 2013

Last NPPES UpdateMarch 18, 20243 updates tracked since enumeration

NPPES CertifiedMarch 18, 2024

✔ NPI 1124456629 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities

Taxonomy Code261QR1300X

Also ListedClinic/Center · Critical Access HospitalTaxonomy 261QC0050X · License 010804 (CO)

Also ListedClinic/Center · Multi-SpecialtyTaxonomy 261QM1300X · License 00.0000156 (CO), 0000156 (CO)

1000 GRANBY PARK DRIVE SOUTH, Granby, CO 80446

Open in Google Maps ↗

Other Names 1

Doing Business AsDba Middle Park Medical Center

Other Identifiers 1

Medicaid9000226213CO

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 06D2035630

Middle Park Medical Center - Granby · Granby, CO

Expired · Jul 31, 2026

CLIA Number06D2035630

Laboratory TypeHospital

Certificate Effective DateJuly 10, 2024

Certificate Expiration DateJuly 31, 2026

Laboratory DirectorDr. Thomas Coburn

Laboratory Phone(970) 887-5847

Laboratory LocationMiddle Park Medical Center - Granby1000 Granby Park Dr South, Granby, CO 80446

CLIA data matches this NPI record on: Address

This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALEXI KIMBALL PERKINS PA-C

Physician Assistant