GRAND JUNCTION PEDIATRIC SPECIALTY CLINIC
NPI 1528837416
Pediatrics in Grand Junction, CO

Q: What is Intermountain Medical Group Grand Junction, LLC's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Active since December 20, 2023CLIA 06D0940033 · Waiver

2643 PATTERSON RD STE 405, GRAND JUNCTION, CO 81506(970) 298-7440(970) 298-7459 Get Directions Write a Review

NPPES record last updated: June 28, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Grand Junction Pediatric Specialty Clinic NPPES

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

GRAND JUNCTION PEDIATRIC SPECIALTY CLINIC (NPI 1528837416) is a healthcare organization registered as a pediatrics in Grand Junction, Colorado and active in the NPI registry since December 2023. The organization holds a CLIA Waiver certificate valid through February 3, 2028 and lists Jon Mcdaniel, Vp Finance Medical Group, as its authorized official.

NPPES Registry Identity

NPI1528837416

Entity TypeOrganization

Primary Taxonomy208000000X

Legal Business NameINTERMOUNTAIN MEDICAL GROUP GRAND JUNCTION, LLC

Location Address2643 PATTERSON RD STE 405Grand Junction, CO 81506-1937

Mailing Address500 Eldorado Blvd Ste 4300Broomfield, CO 80021-3564 · (303) 272-0566 · Fax (303) 272-0390

Phone(970) 298-7440

Fax(970) 298-7459

Organization SubpartYesParent: Intermountain Front Range, Inc.

Authorized OfficialJon McdanielVp Finance Medical Group · (303) 272-0231

Enumeration DateDecember 20, 2023

Last NPPES UpdateJune 28, 2024

NPPES CertifiedJune 28, 2024

✔ NPI 1528837416 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Also ListedPediatrics · Pediatric CardiologyTaxonomy 2080P0202X

2643 PATTERSON RD STE 405, Grand Junction, CO 81506

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Other Names 1

Doing Business AsGrand Junction Pediatric Specialty Clinic

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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 Waiver 06D0940033

Grand Junction Pediatric Specialty Clinic · Grand Junction, CO

Active · expires Feb 3, 2028

CLIA Number06D0940033

Laboratory TypePhysician Office

Certificate Effective DateFebruary 4, 2026

Certificate Expiration DateFebruary 3, 2028

Laboratory DirectorTheresa Moffitt

Laboratory Phone(970) 298-7440

Laboratory LocationGrand Junction Pediatric Specialty Clinic2643 Patterson Rd, Ste 405, Grand Junction, CO 81506

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

INTERMOUNTAIN MEDICAL GROUP GRAND JUNCTION, LLC

Internal Medicine (Nephrology)

2643 PATTERSON RD STE 405
GRAND JUNCTION, CO 81506

Mesa County (970) 298-5920

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Intermountain Medical Group Grand Junction, LLC's NPI number?

The NPI number for Intermountain Medical Group Grand Junction, LLC is 1528837416. It was assigned to this organization in the NPPES registry on December 20, 2023. The provider is doing business as Grand Junction Pediatric Specialty Clinic.

Where is Intermountain Medical Group Grand Junction, LLC located?

Intermountain Medical Group Grand Junction, LLC is located at 2643 Patterson Rd Ste 405, Grand Junction, CO 81506. The listed phone number is (970) 298-7440.

What is Intermountain Medical Group Grand Junction, LLC's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Intermountain Medical Group Grand Junction, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 06D0940033) is associated with this NPI, valid through February 3, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Intermountain Medical Group Grand Junction, LLC was last updated on June 28, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.