NPIMap

Organization Active NPI

Colorado Medical Group, PLLC

Doing business as United Vein Centers of Centennial, CO

  • Vascular Surgery Physician
  • Englewood, CO
National Provider Identifier
1053928234
Registry record updated Jul 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
COLORADO MEDICAL GROUP, PLLC
Doing business as
United Vein Centers of Centennial, CO
Practice address
3535 S Lafayette St Ste 100
Englewood, CO 80113-3954
Phone
(800) 991-6117
Fax
(888) 812-8191
NPI assigned
Sep 30, 2020
Last updated
Jul 24, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
COLORADO MEDICAL GROUP, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 24, 2023

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

Authorized official

Name
Grace Simmons
Title
Credentialing Director
Phone
(813) 867-0606

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU
Vascular Surgery Physician 2086S0129X NU Primary

Addresses

Primary practice location

3535 S Lafayette St Ste 100
Englewood, CO 80113-3954

Mailing address

3810 Northdale Blvd Ste 150
Tampa, FL 33624-1871
Phone (813) 961-1331

Other practice location 1

1044 S 88th St Ste 105
Louisville, CO 80027-9418
Phone (800) 991-6117

Other practice location 2

255 Union Blvd Ste 300
Lakewood, CO 80228-1859
Phone (800) 991-6117

Other practice location 3

3665 John F Kennedy Pkwy Ste 200
Fort Collins, CO 80525-3152
Phone (800) 991-6117

Other names 1

  • United Vein Centers of Centennial, CO Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Colorado Medical Group PLLC6 organizations share this tax ID, including this one
Part of
Colorado Medical Group PLLC

Other organizations with this tax ID 5

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

Locations

6979 S Holly Cir
Ste 125
Centennial, CO 80112

Practitioners & affiliated clinicians

Practitioners 27

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.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1601424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690156800000",
    "number": "1053928234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3810 NORTHDALE BLVD STE 150",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336241871",
            "telephone_number": "813-961-1331",
            "fax_number": "888-850-8316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 S LAFAYETTE ST STE 100",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801133954",
            "telephone_number": "800-991-6117",
            "fax_number": "888-812-8191"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1044 S 88th St Ste 105",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "CO",
            "postal_code": "800279418",
            "country_code": "US",
            "telephone_number": "800-991-6117",
            "fax_number": "888-812-8191",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "255 Union Blvd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "CO",
            "postal_code": "802281859",
            "country_code": "US",
            "telephone_number": "800-991-6117",
            "fax_number": "888-812-8191",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3665 John F Kennedy Pkwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Fort Collins",
            "state": "CO",
            "postal_code": "805253152",
            "country_code": "US",
            "telephone_number": "800-991-6117",
            "fax_number": "888-812-8191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COLORADO MEDICAL GROUP, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COLORADO MEDICAL GROUP, PLLC",
        "enumeration_date": "2020-09-30",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "GRACE",
        "authorized_official_title_or_position": "CREDENTIALING DIRECTOR",
        "authorized_official_telephone_number": "813-867-0606"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "United Vein Centers of Centennial, CO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Englewood, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; 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.