Kaiser Foundation Health Plan of Co
Organization Active NPI Multi-Specialty Clinic/Center · Wheatridge, CO
NPI 1003920786 · NPPES record last updated May 25, 2021
Key facts
- NPI
- 1003920786
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Multi-Specialty Clinic/Center 261QM1300X
- Legal business name
- KAISER FOUNDATION HEALTH PLAN OF CO
- Practice address
- 70 Executive Center II
4851 Independence Street Suite 270
Wheatridge, CO 80033 - Phone
- (303) 467-5850
- NPI assigned
- Aug 18, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- KAISER PERMANENTE
Authorized official
- Name
- Michael S Ramseier
- Title
- Regional President
- Phone
- (303) 344-7256
Corporate family (same tax ID) 12
Practitioners 4
-
Martha Spano, PSY.D.
National Provider Directory
- Tax ID family
- Kaiser Permanente Foundation Healthplan of Colorado
- Part of
- Kaiser Permanente Foundation Healthplan of Colorado
Locations
4851 Independence St
Ste 270
Wheat Ridge, CO 80033
Phone (303) 467-5767
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | |||
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | |||
| Multi-Specialty Clinic/Center | 261QM1300X | Yes |
Addresses
Primary practice location
70 Executive Center II
4851 Independence Street Suite 270
Wheatridge, CO 80033
Mailing address
10350 E Dakota Ave
Denver, CO 80247-1314
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30478251 | Medicaid | CO | |
| 04020087 | Medicaid | CO | |
| 04510301 | Medicaid | CO | |
| 04710083 | Medicaid | CO |
Other names
- Executive Center MH
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways | Health Information Exchange (HIE) |
Other providers in Wheatridge, CO
- A Caring Heart LLC
- Rian M Bovard-Johns
- D Malcolm Strange DDS PC
- Shannon Horn
- Juanita Dolores Lopez
- Promilla Mehra
- Monarch Recovery Services, LLC
- Dennis William Ortega I
- Robert P Domaleski MD PC
All providers in Wheatridge, CO · Multi-Specialty Clinic/Center in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 25, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.