Individual provider Active NPI

Walter B Vernon, MD

  • Surgery Physician
  • Denver, CO
National Provider Identifier
1013005024
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
31476 Issued in CO
Practice address
1601 E 19TH Ave Ste 4600
Denver, CO 80218-1289
Phone
(303) 952-2300
NPI assigned
Oct 11, 2006
Last updated
Nov 19, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 31476 CO Primary

Addresses

Primary practice location

1601 E 19TH Ave Ste 4600
Denver, CO 80218-1289

Mailing address

8490 E Crescent Pkwy Ste 380
Greenwood Village, CO 80111-2815
Phone (303) 957-1310

Other identifiers 1

IdentifierTypeStateIssuer
01314764MedicaidCO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ben.vernon@surgone.directbygreenway.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110119000995 CO Practitioner - General Surgery 4880646496 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
31476COMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Surgone, PC Surgery Current Accepting new patients
Traumaone, PLLC CurrentSince Jun 2, 2017 Accepting new patients

Locations

2350 Meadows Blvd
Castle Rock, CO 80109
Phone (720) 248-3413

1601 E 19th Ave
Ste 4600
Denver, CO 80218
Phone (303) 260-5092

1601 E 19th Ave
Ste 6300
Denver, CO 80218
Phone (303) 839-5669

4545 E 9th Ave
Ste 375
Denver, CO 80220
Phone (303) 296-1370

3333 S Bannock St
Ste 350
Englewood, CO 80110
Phone (303) 957-1310

601 E Hampden Ave
Ste 470
Englewood, CO 80113
Phone (303) 788-3100

8490 E Crescent Pkwy
Ste 380
Greenwood Village, CO 80111
Phone (303) 957-1310

Interoperability endpoints

  • Direct secure messaging: ben.vernon@surgone.directbygreenway.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1013005024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8490 E CRESCENT PKWY STE 380",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801112815",
            "telephone_number": "303-957-1310",
            "fax_number": "303-761-4252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 E 19TH AVE STE 4600",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802181289",
            "telephone_number": "303-952-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERNON",
        "first_name": "WALTER",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CO",
            "license": "31476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01314764",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ben.vernon@surgone.directbygreenway.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4545 E 9th Ave Ste 375",
            "city": "Denver",
            "state": "CO",
            "country_code": "US",
            "postal_code": "802203987",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.