SUSAN BOACKLE CHILDRESS MD NPI 1235229915

NPI Information

NPI: 1235229915
Provider Name: SUSAN BOACKLE CHILDRESS, MD
Classification: Internal Medicine - 207RR0500X
Entity Type: Individual

Specialization: Rheumatology

PECOS Registration: Yes

Address:
12605 E 16TH AVE
AURORA, CO
ZIP 80045
Phone: (720) 848-0000
Get Directions

Susan Boackle Childress, MD is a rheumatology internal medicine in Aurora, CO with 35 years of experience. The provider is an internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases. Susan Boackle Childress, MD NPI is 1235229915. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF ALABAMA SCHOOL OF MEDICINE
Graduation Year:1989

The provider's business location address is:

12605 E 16TH AVE
AURORA, CO
ZIP 80045-545
Phone: (720) 848-0000

The NPI 1235229915 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/13/2006 and was last updated on 5/9/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RR0500X	Internal Medicine	Rheumatology	35598	COLORADO	No
2	207RR0500X	Internal Medicine	Rheumatology	H7909	TEXAS	No
3	207RR0500X	Internal Medicine	Rheumatology	MD.43902	ALABAMA	No
4	207RR0500X	Internal Medicine	Rheumatology	335634	LOUISIANA	No
5	207RR0500X	Internal Medicine	Rheumatology	CDRH.0035598	COLORADO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	01355981	MEDICAID	COLORADO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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