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

NPI Status: Active since October 18, 2013

Contact Information

1000 GRANBY PARK DRIVE SOUTH
GRANBY, CO
ZIP 80446
Phone: (970) 724-3442
Fax: (970) 724-9606

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  • Organization
  • Clinic/Center
  • Rural Health
  • CLIA Number: 06D2035630
  • CLIA Cert. Type: Hospital
  • CLIA Exp. Date: 07-09-2026

About DBA MIDDLE PARK MEDICAL CENTER

This page provides the complete NPI Profile along with additional information for Dba Middle Park Medical Center, a primary care provider established in Granby, Colorado operating as a Clinic/center, focusing in rural health . The healthcare provider is registered in the NPI registry with number 1124456629 assigned on October 2013. The practitioner's primary taxonomy code is 261QR1300X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The provider's is doing business as Dba Middle Park Medical Center. The authorized official of this NPI record is Jason Marshall Cleckler (Ceo)

NPI
1124456629
Provider Legal Name
KREMMLING MEMORIAL HOSPITAL DISTRICT
Other Organization Name
DBA MIDDLE PARK MEDICAL CENTER
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
1000 GRANBY PARK DRIVE SOUTH GRANBY, CO 80446
Location Phone
(970) 724-3442
Location Fax
(970) 724-9606
Mailing Address
PO BOX 399 KREMMLING, CO 80459
Mailing Phone
(970) 724-3442
Mailing Fax
(970) 724-9606
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
10-18-2013
Last Update Date
03-18-2024
Code Navigator

A primary care provider (PCP) like Dba Middle Park Medical Center sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Rural Health

Taxonomy Code
261QR1300X
Type
Ambulatory Health Care Facilities
License State
CO

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1261QC0050XAmbulatory Health Care Facilities

Clinic/Center
Critical Access Hospital

010804 (CO)
2261QM1300XAmbulatory Health Care Facilities

Clinic/Center
Multi-Specialty

00.0000156 (CO)
3261QM1300XAmbulatory Health Care Facilities

Clinic/Center
Multi-Specialty

0000156 (CO)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

JASON MARSHALL CLECKLER

Authorized Official Title
CEO
Authorized Official Phone
(970) 208-2907

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
9000226213MEDICAID (05)CO 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
06D2035630
Facility Type
Hospital
Certificate Effective Date
July 10, 2024
Certificate Expiration Date
July 09, 2026
Laboratory Director
DR. THOMAS COBURN
Certificate Type
Certificate of Compliance
Certificate Type Description
This CLIA certificate is issued to Dba Middle Park Medical Center after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1124456629, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
2
Doubled → 4
Pos 4
4
Unchanged
Pos 5
4
Doubled → 8
Pos 6
5
Unchanged
Pos 7
6
Doubled → 12 → 1 + 2
Pos 8
6
Unchanged
Pos 9
2
Doubled → 4
Check
9
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 2 → 4 4 → 8 6 → 12 → 3 2 → 4

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 4 + 4 + 8 + 5 + 1 + 2 + 6 + 4 + 24 = 61

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 61 is 70. The difference is the calculated check digit.

70 - 61 = 9
This NPI is valid
The calculated check digit is 9, which matches the last digit of 1124456629.

Other Providers at the Same Location


The following 7 providers are registered at the same or a nearby location.

Physical Therapist
1000 GRANBY PARK DRIVE SOUTH
GRANBY, CO 80446
Physical Medicine & Rehabilitation
1000 GRANBY PARK DRIVE SOUTH
GRANBY, CO 80446
Nurse Practitioner (Pediatrics)
1000 GRANBY PARK DRIVE SOUTH
GRANBY, CO 80446
Family Medicine
1000 GRANBY PARK DRIVE SOUTH
GRANBY, CO 80446
Nurse Anesthetist, Certified Registered
1000 GRANBY PARK DRIVE SOUTH
GRANBY, CO 80446
Medicare Defined Swing Bed Unit
1000 GRANBY PARK DRIVE SOUTH
GRANBY, CO 80446
Physician Assistant
1000 GRANBY PARK DRIVE SOUTH
GRANBY, CO 80446

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1124456629, enumerated as an "organization" on October 18, 2013.

The provider is located at 1000 GRANBY PARK DRIVE SOUTH GRANBY, CO 80446 and the phone number is (970) 724-3442.

Clinic/Center with taxonomy code 261QR1300X and a focus in Rural Health.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.