Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Pediatric Associates of Canon City, Prof. LLC

Pediatric Adolescent Medicine Physician in Canon City, CO · enumerated 2007 · authorized official Roger Noland, General Manager.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1457498131

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Registry record

Entity type Organization (Type 2)

Legal business name Pediatric Associates of Canon City, Prof. LLC

Practice address 1335 Phay Ave, Suite A, Canon City, CO, 81212

Phone (719) 269-1727

Fax (719) 269-1730

Enumeration date Jan 31, 2007

Last updated in NPPES Aug 22, 2020

Taxonomy & classification

2080A0000X Pediatric Adolescent Medicine Physician Allopathic & Osteopathic Physicians · License 23117 (CO) Primary

Authorized official

Name Roger Noland

Title General Manager

Phone (719) 269-1727

Other identifiers

Identifier	Type	State	Issuer
05638655	Medicaid	CO	-
01271139	Medicaid	CO	-

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2020-08-22. Verify at npiregistry.cms.hhs.gov.

Where is Pediatric Associates of Canon City, Prof. LLC located?

The practice location on file with NPPES is in Canon City, CO.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2020-08-22.