NPIMap

Organization Active NPI

Immersiv Health of Colorado, PLLC

Doing business as Immersiv Health

  • Infectious Disease Physician
  • Greeley, CO
National Provider Identifier
1043043466
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
Legal business name
IMMERSIV HEALTH OF COLORADO, PLLC
Doing business as
Immersiv Health
Practice address
1715 61St Ave Ste 103
Greeley, CO 80634-7989
Phone
(877) 551-6650
Fax
(855) 694-4656
NPI assigned
Aug 21, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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

Authorized official

Name
Son Han
Title
Ceo
Phone
(512) 869-9323

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0200X Primary

Addresses

Primary practice location

1715 61St Ave Ste 103
Greeley, CO 80634-7989

Mailing address

382 NE 191St St Ste 93920
Miami, FL 33179-3899
Phone (877) 551-6650

Other names 1

  • Immersiv Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241030002387 CO Part B Supplier - Clinic/Group Practice 5395278246 Receives reassigned benefits from 7 practitioners
Practice locations: Castle Pines, CO; Greeley, CO; Fort Collins, CO; Colorado Springs, CO; Englewood, CO

National Provider Directory

National Provider Directory
Tax ID family
Immersiv Health6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

7505 Village Square Dr
Ste 105
Castle Pines, CO 80108
Phone (303) 814-8000

1075 W Horsetooth Rd
Unit 208
Fort Collins, CO 80526
Phone (512) 869-9323

1715 61st Ave
Ste 103
Greeley, CO 80634
Phone (512) 869-9323

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1724198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750809600000",
    "number": "1043043466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "382 NE 191ST ST STE 93920",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331793899",
            "telephone_number": "877-551-6650",
            "fax_number": "855-694-4656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 61ST AVE STE 103",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806347989",
            "telephone_number": "877-551-6650",
            "fax_number": "855-694-4656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMMERSIV HEALTH OF COLORADO, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-21",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A",
        "authorized_official_last_name": "HAN",
        "authorized_official_first_name": "SON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "512-869-9323"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Immersiv Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Immersiv Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greeley, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2025; 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.