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

Last updated

Jun 7, 2021By the provider in NPPES

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, MDNPI 1619912904

Title

Executive Director

Phone

(303) 781-1909

Specialties & licenses 1

Addresses

Locations

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.

• Lisa S Kettering, MD

  • Internal Medicine Physician
  • Englewood, CO
  • NPI 1619912904
  Authorized official Same address or phone

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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• Internal Medicine Physician in Englewood, CO
• Providers in Englewood, CO by specialty
• Internal Medicine Physician in Colorado

• 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.