Active NPI
Intermountain Medical Group Denver, LLC
- Family Medicine Physician
- Denver, CO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- 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.
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | |||
| Family Medicine Physician | 207Q00000X | Primary | ||
| Internal Medicine Physician | 207R00000X | |||
| Cardiovascular Disease Physician | 207RC0000X | |||
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | |||
| Hospice and Palliative Medicine (Internal Medicine) Physician | 207RH0002X | |||
| Hematology & Oncology Physician | 207RH0003X | |||
| Neurological Surgery Physician | 207T00000X | |||
| Obstetrics & Gynecology Physician | 207V00000X | |||
| Maternal & Fetal Medicine Physician | 207VM0101X | |||
| Orthopaedic Surgery Physician | 207X00000X | |||
| Physical Medicine & Rehabilitation Physician | 208100000X | |||
| Plastic Surgery Physician | 208200000X | |||
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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).
-
- Sports Medicine (Orthopaedic Surgery) Physician
- Denver, CO
- NPI 1083598874
0840513552
-
- Foot & Ankle Surgery Podiatrist
- Thornton, CO
- NPI 1730533902
0840513552
-
- General Practice Physician
- Billings, MT
- NPI 1669192134
0840513552
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.
-
- Cardiovascular Disease Physician
- Brighton, CO
- NPI 1831516848
Cardiovascular Disease, CO
-
- Advanced Heart Failure and Transplant Cardiology Physician
- Denver, CO
- NPI 1912911017
Cardiovascular Disease, CO
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": []
}
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- Intermountain Medical Group Denver, LLC
- Intermountain Medical Group Denver, LLC
- Intermountain Medical Group Denver, LLC
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.