Linc MD, PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

33071 Issued in CO

Legal business name

LINC MD, PLLC

Practice address

4 Gooseberry LN
Englewood, CO 80113-4126

Phone

(393) 781-1909

NPI assigned

Mar 8, 2016

Organization subpart

No

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

Authorized official

Name

Lisa S Kettering, MD

Title

Executive Director

Phone

(303) 781-1909

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1457395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623024000000",
    "number": "1043671803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 BUCHTEL BOULEVARD",
            "address_2": "# 100758",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802500758",
            "telephone_number": "303-781-1909",
            "fax_number": "720-306-2469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 GOOSEBERRY LN",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801134126",
            "telephone_number": "393-781-1909"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3800 Buchtel Boulevard",
            "address_2": "# 100758",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802500758",
            "country_code": "US",
            "telephone_number": "303-781-1909",
            "fax_number": "720-306-2469",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LINC MD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-08",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A",
        "authorized_official_last_name": "KETTERING",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "303-781-1909",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "33071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; 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.