NPIMap

Organization Active NPI

Healogics Specialty Physicians of Colorado-Professional, LLC

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Parker, CO
National Provider Identifier
1114331006
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianTaxonomy code 2083P0011X
Legal business name
HEALOGICS SPECIALTY PHYSICIANS OF COLORADO-PROFESSIONAL, LLC
Practice address
9399 Crown Crest Blvd Ste 430
Parker, CO 80138-8527
Phone
(303) 269-2310
Fax
(303) 269-2319
NPI assigned
Jun 18, 2014
Last updated
Jun 1, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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

Authorized official

Name
Frank Williams
Title
Ceo
Phone
(855) 689-5105

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU
Physical Medicine & Rehabilitation Physician 208100000X NU
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician 2083P0011X NU Primary
Surgery Physician 208600000X NU
General Practice Physician 208D00000X NU
Nurse Practitioner 363L00000X NU
Clinical Nurse Specialist 364S00000X NU

Addresses

Primary practice location

9399 Crown Crest Blvd Ste 430
Parker, CO 80138-8527

Mailing address

PO Box 645743
Cincinnati, OH 45264-6018
Phone (855) 689-5105

Other identifiers 2

IdentifierTypeStateIssuer
35233559MedicaidCO
1114331006OtherCONPI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150318000983 CO Part B Supplier - Clinic/Group Practice 4183941834 Receives reassigned benefits from 50 practitioners
1 other NPI on this enrollment
Practice locations: Denver, CO; Pueblo, CO; Parker, CO; Longmont, CO; Littleton, CO; Lakewood, CO; Grand Junction, CO; Durango, CO…

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1010 Three Springs Blvd
Ste 200B
Durango, CO 81301
Phone (709) 764-3390

1950 Mountain View Ave
Ste 4
Longmont, CO 80501

Practitioners & affiliated clinicians

Practitioners 51

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 51

NPI Registry JSON

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

{
    "created_epoch": "1403049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685577600000",
    "number": "1114331006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 645743",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452646018",
            "telephone_number": "855-689-5105",
            "fax_number": "904-446-3032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9399 CROWN CREST BLVD STE 430",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801388527",
            "telephone_number": "303-269-2310",
            "fax_number": "303-269-2319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALOGICS SPECIALTY PHYSICIANS OF COLORADO-PROFESSIONAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-18",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "855-689-5105"
    },
    "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": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2083P0011X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "35233559",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1114331006",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Parker, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; 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.