Organization Active NPI

Intermountain Medical Group Denver, LLC

  • Family Medicine Physician
  • Denver, CO
National Provider Identifier
1083021083
Registry record updated Jun 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
INTERMOUNTAIN MEDICAL GROUP DENVER, LLC
Practice address
1960 N Ogden St Ste 110
Denver, CO 80218-3667
Phone
(303) 318-2460
Fax
(303) 318-2489
NPI assigned
Jul 22, 2014
Organization subpart
Yes
Parent organization
INTERMOUNTAIN FRONT RANGE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 10, 2026

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

Authorized official

Name
Jon McDaniel
Title
VP Finance - MGPS Operations
Phone
(303) 272-0231

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207P00000X
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X
Cardiovascular Disease PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RC0000X
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RE0101X
Hospice and Palliative Medicine (Internal Medicine) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RH0002X
Hematology & Oncology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RH0003X
Neurological Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207T00000X
Obstetrics & Gynecology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207V00000X
Maternal & Fetal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207VM0101X
Orthopaedic Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207X00000X
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208100000X
Plastic Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208200000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208G00000X
Mammography Clinic/Center 261QR0206X

Addresses

Primary practice location

1960 N Ogden St Ste 110
Denver, CO 80218-3667

Mailing address

500 Eldorado Blvd Ste 4300
Broomfield, CO 80021-3564
Phone (855) 851-4127

Other practice location 1

3655 Lutheran Pkwy Ste 201
Wheat Ridge, CO 80033-6010
Phone (303) 603-9800

Other practice location 2

12169 Sheridan Blvd
Broomfield, CO 80020-2459
Phone (303) 603-9400

Other practice location 3

2055 W 136th Ave Unit B118
Broomfield, CO 80023-9308
Phone (303) 673-1570

Other practice location 4

325 S Teller St Ste 250
Lakewood, CO 80226-7429
Phone (303) 403-6600

Other practice location 5

1181 E 120th Ave Unit A
Thornton, CO 80233-5729
Phone (303) 673-1500

Other practice location 6

8350 Colorado Blvd Unit 160
Firestone, CO 80504-6803
Phone (303) 689-5160

Other practice location 7

300 Exempla Cir Ste 310
Lafayette, CO 80026-3394
Phone (303) 689-6420

Other practice location 8

16570 Washington St
Thornton, CO 80023-8964
Phone (303) 689-6600

Other practice location 9

500 Eldorado Blvd Ste 4250
Broomfield, CO 80021-3408
Phone (855) 851-4127

Other practice location 10

12790 W Alameda Pkwy Ste A
Lakewood, CO 80228-2850
Phone (303) 403-6350

Other practice location 11

3555 Lutheran Pkwy Ste 180
Wheat Ridge, CO 80033-6000
Phone (303) 403-7933

Other practice location 12

1027 N 27th St
Billings, MT 59101-0711
Phone (406) 237-5110

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150106000131 CO Part B Supplier - Clinic/Group Practice 0840513552 Receives reassigned benefits from 1,361 practitioners

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Part of
Lutheran Medical Center

Locations (25 of 48)

15389 W 91st Dr
Arvada, CO 80007
Phone (303) 603-9300

15389 W 91st Dr
Ste 100
Arvada, CO 80007
Phone (303) 603-9300

23750 E 14th Ave
Ste 310
Aurora, CO 80018
Phone (303) 272-0500

2055 W 136th Ave
Unit B118
Broomfield, CO 80023
Phone (303) 673-1570

2055 W 136th Ave
Broomfield, CO 80023

2055 W 136th Ave
Ste B118
Broomfield, CO 80023
Phone (303) 673-1570

2055 W 136th Ave
Ste 118
Broomfield, CO 80023

2055 W 136th Ave
#B118
Broomfield, CO 80023

500 Eldorado Blvd
Ste 4250
Broomfield, CO 80021
Phone (303) 813-5590

16677 Lowell Blvd
Ste 100
Broomfield, CO 80023
Phone (303) 415-8820

7200 S Alton Way
Centennial, CO 80112
Phone (303) 945-7063

1400 Jackson St
Bldg 550
Denver, CO 80206

1960 N Ogden St
Ste 330
Denver, CO 80218
Phone (303) 318-2610

1601 Lowell Blvd
Ste 150
Denver, CO 80204
Phone (303) 403-6820

1960 N Ogden St
Ste 550
Denver, CO 80218
Phone (303) 318-1585

1960 N Ogden St
Ste 690
Denver, CO 80218
Phone (303) 318-3580

1960 N Ogden St
Ste 11
Denver, CO 80218

1830 N Franklin St
Ste 340
Denver, CO 80218
Phone (303) 318-3330

1960 N Ogden St
Ste 540A
Denver, CO 80218
Phone (303) 318-2455

835 E 18th Ave
#110
Denver, CO 80218

8900 E 46th Pl
Denver, CO 80238
Phone (303) 403-6300

63 N Quebec St
Ste 201
Denver, CO 80230
Phone (303) 248-7897

1960 N Ogden St
Ste 340
Denver, CO 80218
Phone (303) 318-3816

4704 Harlan St
Ste 500
Denver, CO 80212
Phone (303) 232-5354

12905 W 40th Ave
Ste 305
Golden, CO 80401
Phone (303) 265-5730

Practitioners & affiliated clinicians

Practitioners 1,444

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

View all 1,444

NPI Registry JSON

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

{
    "created_epoch": "1405987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781049600000",
    "number": "1083021083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 ELDORADO BLVD STE 4300",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800213564",
            "telephone_number": "855-851-4127",
            "fax_number": "303-272-0390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1960 N OGDEN ST STE 110",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802183667",
            "telephone_number": "303-318-2460",
            "fax_number": "303-318-2489"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3655 Lutheran Pkwy Ste 201",
            "address_purpose": "LOCATION",
            "city": "Wheat Ridge",
            "state": "CO",
            "postal_code": "800336010",
            "country_code": "US",
            "telephone_number": "303-603-9800",
            "fax_number": "303-403-6209",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12169 Sheridan Blvd",
            "address_purpose": "LOCATION",
            "city": "Broomfield",
            "state": "CO",
            "postal_code": "800202459",
            "country_code": "US",
            "telephone_number": "303-603-9400",
            "fax_number": "303-603-9420",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2055 W 136th Ave Unit B118",
            "address_purpose": "LOCATION",
            "city": "Broomfield",
            "state": "CO",
            "postal_code": "800239308",
            "country_code": "US",
            "telephone_number": "303-673-1570",
            "fax_number": "303-673-1331",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "325 S Teller St Ste 250",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "CO",
            "postal_code": "802267429",
            "country_code": "US",
            "telephone_number": "303-403-6600",
            "fax_number": "303-403-6493",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1181 E 120th Ave Unit A",
            "address_purpose": "LOCATION",
            "city": "Thornton",
            "state": "CO",
            "postal_code": "802335729",
            "country_code": "US",
            "telephone_number": "303-673-1500",
            "fax_number": "303-689-6664",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8350 Colorado Blvd Unit 160",
            "address_purpose": "LOCATION",
            "city": "Firestone",
            "state": "CO",
            "postal_code": "805046803",
            "country_code": "US",
            "telephone_number": "303-689-5160",
            "fax_number": "303-689-5175",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Exempla Cir Ste 310",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "CO",
            "postal_code": "800263394",
            "country_code": "US",
            "telephone_number": "303-689-6420",
            "fax_number": "303-689-6430",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16570 Washington St",
            "address_purpose": "LOCATION",
            "city": "Thornton",
            "state": "CO",
            "postal_code": "800238964",
            "country_code": "US",
            "telephone_number": "303-689-6600",
            "fax_number": "303-689-6601",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 Eldorado Blvd Ste 4250",
            "address_purpose": "LOCATION",
            "city": "Broomfield",
            "state": "CO",
            "postal_code": "800213408",
            "country_code": "US",
            "telephone_number": "855-851-4127",
            "fax_number": "303-272-0390",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12790 W Alameda Pkwy Ste A",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "CO",
            "postal_code": "802282850",
            "country_code": "US",
            "telephone_number": "303-403-6350",
            "fax_number": "303-403-6372",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3555 Lutheran Pkwy Ste 180",
            "address_purpose": "LOCATION",
            "city": "Wheat Ridge",
            "state": "CO",
            "postal_code": "800336000",
            "country_code": "US",
            "telephone_number": "303-403-7933",
            "fax_number": "303-403-7945",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1027 N 27th St",
            "address_purpose": "LOCATION",
            "city": "Billings",
            "state": "MT",
            "postal_code": "591010711",
            "country_code": "US",
            "telephone_number": "406-237-5110",
            "fax_number": "406-206-2152",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INTERMOUNTAIN MEDICAL GROUP DENVER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INTERMOUNTAIN FRONT RANGE, INC.",
        "enumeration_date": "2014-07-22",
        "last_updated": "2026-06-10",
        "certification_date": "2026-06-10",
        "status": "A",
        "authorized_official_last_name": "MCDANIEL",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "VP FINANCE - MGPS OPERATIONS",
        "authorized_official_telephone_number": "303-272-0231"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0206X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mammography",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2026; 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.