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PEDIATRICS 5280 PC
NPI 1629030689
Clinic/Center - Primary Care in Centennial, CO

Active since April 05, 2006CLIA 06D2061063 · Waiver
9094 E MINERAL AVE, SUITE 120, CENTENNIAL, CO 80112(303) 779-5437(303) 689-9628 Get Directions Write a Review

NPPES record last updated: July 8, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Pediatrics 5280 Pc NPPES

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

PEDIATRICS 5280 PC (NPI 1629030689), doing business as Pediatrics Dtc Pc, is a healthcare organization registered as a primary care in Centennial, Colorado and active in the NPI registry since April 2006. The organization holds a CLIA Waiver certificate valid through May 17, 2028 and lists Robert Holbrook Stapp, President Physician, as its authorized official.

NPPES Registry Identity

NPI1629030689
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NamePEDIATRICS 5280 PC
Location Address9094 E MINERAL AVE, SUITE 120Centennial, CO 80112-7200
Mailing Address9094 E Mineral Ave, Suite 120Centennial, CO 80112-7200 · (303) 779-5437 · Fax (303) 689-9628
Phone(303) 779-5437
Fax(303) 689-9628
Organization SubpartNo
Authorized OfficialRobert Holbrook StappPresident Physician · (303) 779-5437
Enumeration DateApril 5, 2006
Last NPPES UpdateJuly 8, 2008
✔ NPI 1629030689 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
9094 E MINERAL AVE, Centennial, CO 80112
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Other Names 1

Former Legal Business NamePediatrics Dtc Pc

Other Identifiers 1

Medicaid4013280CO

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 06D2061063

Pediatrics 5280, PC · Castle Rock, CO
Active · expires May 17, 2028
CLIA Number06D2061063
Laboratory TypePhysician Office
Certificate Effective DateMay 18, 2026
Certificate Expiration DateMay 17, 2028
Laboratory DirectorDr. Julie C. Deckerman
Laboratory Phone(303) 779-5437
Laboratory LocationPediatrics 5280, PC2352 Meadows Blvd, Ste 150, Castle Rock, CO 80109
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 12

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

MS. CONSTANCE H GIARRATANA MD
Pediatrics (Adolescent Medicine)
9094 E MINERAL AVE
CENTENNIAL, CO 80112
Arapahoe County (303) 694-3200
DR. JOHN CRAIG BOSLEY M.D.
Pediatrics
9094 E MINERAL AVE, SUITE 120
CENTENNIAL, CO 80112
Arapahoe County (303) 779-5437
MRS. CONNIE CHEN LEUNG PA
Physician Assistant
9094 E MINERAL AVE, SUITE 100
CENTENNIAL, CO 80112
Arapahoe County (303) 694-3200
MS. SUZANNE S COOPER MD
Pediatrics (Adolescent Medicine)
9094 E MINERAL AVE
CENTENNIAL, CO 80112
Arapahoe County (303) 694-3200
DR. MICHELE WALLENDAL MD
Pediatrics
9094 E MINERAL AVE, SUITE 120
CENTENNIAL, CO 80112
Arapahoe County (303) 779-5437
MR. DANIEL J FEITEN MD
Pediatrics (Adolescent Medicine)
9094 E MINERAL AVE
CENTENNIAL, CO 80112
Arapahoe County (303) 694-3200
DR. JAMES ROBERT LESSIG DDS
Dentist (Oral and Maxillofacial Surgery)
9094 E MINERAL AVE, SUITE 260
CENTENNIAL, CO 80112
Arapahoe County (303) 768-8570
CHILDREN'S EYE PHYSICIANS P.C.
Ophthalmology (Pediatric Ophthalmology and Strabismus Specialist)
9094 E MINERAL AVE, STE 200
CENTENNIAL, CO 80112
Arapahoe County (303) 456-9456

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 Pediatrics 5280 PC's NPI number?

The NPI number for Pediatrics 5280 PC is 1629030689. It was assigned to this organization in the NPPES registry on April 5, 2006. The provider was formerly known as Pediatrics Dtc PC.

Where is Pediatrics 5280 PC located?

Pediatrics 5280 PC is located at 9094 E Mineral Ave Suite 120, Centennial, CO 80112. The listed phone number is (303) 779-5437.

What is Pediatrics 5280 PC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does Pediatrics 5280 PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 06D2061063) is associated with this NPI, valid through May 17, 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 Pediatrics 5280 PC was last updated on July 8, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.