NPIMap

Organization Active NPI

Plasticity Centers of Colorado LLC

  • Multi-Specialty Clinic/Center
  • Littleton, CO
National Provider Identifier
1023627684
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
PLASTICITY CENTERS OF COLORADO LLC
Practice address
991 Southpark Dr Ste 200
Littleton, CO 80120-5689
Phone
(720) 912-2212
Fax
(720) 912-2212
NPI assigned
Jul 29, 2020
Last updated
Aug 10, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Authorized official

Name
Shaun KornfeldNPI 1356809784
Title
Lead Clinician
Phone
(720) 912-2212

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
Neurology ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NN0400X
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

991 Southpark Dr Ste 200
Littleton, CO 80120-5689

Mailing address

991 Southpark Dr Ste 200
Littleton, CO 80120-5689
Phone (720) 912-2212

National Provider Directory

National Provider Directory
Tax ID family
Plasticity Brain Centers of Orlando LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2899 N Speer Blvd
Unit 103
Denver, CO 80211

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1595980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660089600000",
    "number": "1023627684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "991 SOUTHPARK DR STE 200",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801205689",
            "telephone_number": "720-912-2212",
            "fax_number": "720-912-2212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "991 SOUTHPARK DR STE 200",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801205689",
            "telephone_number": "720-912-2212",
            "fax_number": "720-912-2212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLASTICITY CENTERS OF COLORADO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-29",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A",
        "authorized_official_last_name": "KORNFELD",
        "authorized_official_first_name": "SHAUN",
        "authorized_official_title_or_position": "LEAD CLINICIAN",
        "authorized_official_telephone_number": "720-912-2212"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "111NN0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Littleton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.