NPIMap

Organization Active NPI

Panorama Orthopedics & Spine Center, PC

Doing business as Rocky Mountain Spine and Sport

  • Physical Therapy Clinic/Center
  • Wheat Ridge, CO
National Provider Identifier
1003574054
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
PANORAMA ORTHOPEDICS & SPINE CENTER, PC
Doing business as
Rocky Mountain Spine and Sport
Practice address
3916 Wadsworth Blvd
Wheat Ridge, CO 80033-4615
Phone
(720) 805-2302
Fax
(720) 573-6704
NPI assigned
Dec 6, 2021
Last updated
Dec 6, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Mark J Conklin, MD
Title
President
Phone
(303) 274-7321

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NU Primary

Addresses

Primary practice location

3916 Wadsworth Blvd
Wheat Ridge, CO 80033-4615

Mailing address

660 Golden Ridge Rd Ste 250
Golden, CO 80401-9541
Phone (303) 274-7321

Other names 1

  • ROCKY MOUNTAIN SPINE AND SPORT Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031110000424 CO Part B Supplier - Clinic/Group Practice 8426961087 Receives reassigned benefits from 500 practitioners
20 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Littleton, CO; Golden, CO; Lakewood, CO; Highlands Ranch, CO; Greenwood Village, CO; Lone Tree, CO; Monument, CO; Parker, CO…

Other NPIs on the same Medicare enrollment 20

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 20

National Provider Directory

National Provider Directory
Tax ID family
Lakewood Orthopaedic Clinic61 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 13

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 13

Practitioners & affiliated clinicians

Practitioners 51

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 51

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1638748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638748800000",
    "number": "1003574054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 GOLDEN RIDGE RD STE 250",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804019541",
            "telephone_number": "303-274-7321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3916 WADSWORTH BLVD",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800334615",
            "telephone_number": "720-805-2302",
            "fax_number": "720-573-6704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANORAMA ORTHOPEDICS & SPINE CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-06",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A",
        "authorized_official_last_name": "CONKLIN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "303-274-7321",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ROCKY MOUNTAIN SPINE AND SPORT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wheat Ridge, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.