NPIMap

Organization Active NPI

Intermountain Medical Group Denver, LLC

Doing business as SCL Health Medical Group - Central Park OB-GYN

  • Obstetrics & Gynecology Physician
  • Denver, CO
National Provider Identifier
1124632534
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
INTERMOUNTAIN MEDICAL GROUP DENVER, LLC
Doing business as
SCL Health Medical Group - Central Park OB-GYN
Practice address
2823 Roslyn St
Denver, CO 80238-2624
Phone
(303) 403-6333
Fax
(303) 403-6333
NPI assigned
Sep 2, 2020
Last updated
Jun 28, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
INTERMOUNTAIN FRONT RANGE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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

Authorized official

Name
Jon McDaniel
Title
VP Finance Medical Group
Phone
(303) 272-0231

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X NU Primary
Medical Specialty Clinic/Center 261QM2500X NU

Addresses

Primary practice location

2823 Roslyn St
Denver, CO 80238-2624

Mailing address

2823 Roslyn St
Denver, CO 80238-2624
Phone (303) 403-6333

Other names 1

  • SCL Health Medical Group - Central Park OB-GYN Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D2180449Central Park Clinic - OB-GYN2823 Roslyn Street, Denver, CO 80238Provider-performed microscopyMar 15, 2028

National Provider Directory

National Provider Directory
Tax ID family
SCL Health Medical Group121 organizations share this tax ID, including this one
Part of
Exempla Healthcare

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1599004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719532800000",
    "number": "1124632534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2823 ROSLYN ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802382624",
            "telephone_number": "303-403-6333",
            "fax_number": "303-403-6325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2823 ROSLYN ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802382624",
            "telephone_number": "303-403-6333",
            "fax_number": "303-403-6333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERMOUNTAIN MEDICAL GROUP DENVER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INTERMOUNTAIN FRONT RANGE, INC.",
        "enumeration_date": "2020-09-02",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A",
        "authorized_official_last_name": "MCDANIEL",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "VP FINANCE MEDICAL GROUP",
        "authorized_official_telephone_number": "303-272-0231"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SCL Health Medical Group - Central Park OB-GYN",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SCL Health Medical Group - Central Park OB-GYN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.