Individual provider Active NPI

Madison Tuggle, RDN

  • Registered Dietitian
  • Wheat Ridge, CO
National Provider Identifier
1124751151
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86072561 Issued in CO
Practice address
3455 Lutheran Pkwy Ste 220
Wheat Ridge, CO 80033-6029
Phone
(303) 403-3030
NPI assigned
Jul 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86072561 CO Primary

Addresses

Primary practice location

3455 Lutheran Pkwy Ste 220
Wheat Ridge, CO 80033-6029

Mailing address

10301 W 12TH Ave
Lakewood, CO 80215-4504
Phone (303) 815-0985

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230508002120 CO Practitioner - Registered Dietitian Or Nutrition Professional 0749645190 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
86072561COMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Denver, LLC CurrentSince Dec 7, 2022 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Dec 7, 2022 Accepting new patients
Intermountain Medical Group Denver, LLC Current Accepting new patients

Locations

500 Eldorado Blvd
Ste 4300
Broomfield, CO 80021

12905 W 40th Ave
Ste 405
Golden, CO 80401
Phone (303) 265-5740

3455 Lutheran Pkwy
Ste 220
Wheat Ridge, CO 80033
Phone (303) 403-3030

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1657152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1124751151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10301 W 12TH AVE",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802154504",
            "telephone_number": "303-815-0985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3455 LUTHERAN PKWY STE 220",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800336029",
            "telephone_number": "303-403-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUGGLE",
        "first_name": "MADISON",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-07",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CO",
            "license": "86072561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheat Ridge, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2022; 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.