Boulder Internal Medicine PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

BOULDER INTERNAL MEDICINE PC

Doing business as

Front Range Preventive Imaging

Practice address

2880 Folsom St
Suite 100
Boulder, CO 80304-3769

Phone

(303) 443-7226

Fax

(303) 443-7168

NPI assigned

Oct 4, 2006

Last updated

Mar 26, 2024By 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

William Lawson Blanchet, MDNPI 1659466837

Title

President

Phone

(303) 443-7226

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Front Range Preventive Imaging Doing business as

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 6

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.

• William Lawson Blanchet, MD

  • Internal Medicine Physician
  • Boulder, CO
  • NPI 1659466837
  Medicare reassignment Care Compare group NPD Authorized official
• Amy O Campbell, MD

  • Internal Medicine Physician
  • Boulder, CO
  • NPI 1033108642
  Medicare reassignment Care Compare group NPD
• Jennifer Myia Johnson, M.D.

  • Family Medicine Physician
  • Boulder, CO
  • NPI 1710006382
  Medicare reassignment Care Compare group NPD
• Kylie McBride, FNP-C

  • Family Nurse Practitioner
  • Boulder, CO
  • NPI 1447776737
  Medicare reassignment Care Compare group NPD
• John Robert Campbell, PAC

  • Physician Assistant
  • Boulder, CO
  • NPI 1669575452
  Medicare reassignment Care Compare group
• Aron Charach, DPT

  • Physical Therapist
  • Brooklyn, NY
  • NPI 1699042390
  NPD (past)

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711411200000",
    "number": "1104911361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2880 FOLSOM ST",
            "address_2": "SUITE 100",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803043769",
            "telephone_number": "303-443-7226",
            "fax_number": "303-443-7168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2880 FOLSOM ST",
            "address_2": "SUITE 100",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803043769",
            "telephone_number": "303-443-7226",
            "fax_number": "303-443-7168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOULDER INTERNAL MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A",
        "authorized_official_last_name": "BLANCHET",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "LAWSON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "303-443-7226",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04021960",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Front Range Preventive Imaging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Boulder Integrated Health LLC (Bolder Life)
• Boulder Journey Counseling
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• Boulder Management Services Organization (The Thayer Group for Womens Care)
• Boulder Massage (Boulder Massage & NeuroMuscular Therapy)
• Boulder Medical Center, P.C.

• Internal Medicine Physician in Boulder, CO
• Providers in Boulder, 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 Mar 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.