Active NPI
Park Avenue Surgery Center LLC
- Ambulatory Surgical Clinic/Center
- Denver, CO
National Provider Identifier
1154328508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- License
- 0471
- Legal business name
- PARK AVENUE SURGERY CENTER LLC
- Practice address
- 1800 Emerson St
#220
Denver, CO 80218-1014 - Phone
- (303) 468-8844
- Fax
- (303) 468-8850
- NPI assigned
- Jun 30, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Jerry Kirk Popham, M.D.
- Title
- Physician
- Phone
- (303) 468-8844
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | 0471 | CO | Primary |
Addresses
Primary practice location
1800 Emerson St
#220
Denver, CO 80218-1014
Mailing address
1800 Emerson St
#200
Denver, CO 80218-1014
Phone (303) 468-8844
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0471 | Other | CO | STATE LICENSE |
National Provider Directory
National Provider Directory- Tax ID family
- Park Avenue Surgery Center
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Ambulatory Surgical Clinic/Center
- Denver, CO
- NPI 1689748758
Locations
1800 N Emerson St
Ste 220
Denver, CO 80218
Phone (303) 468-8844
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Ophthalmology Physician
- Denver, CO
- NPI 1588661920
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120089600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1154328508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1800 EMERSON ST",
"address_2": "#200",
"city": "DENVER",
"state": "CO",
"postal_code": "802181014",
"telephone_number": "303-468-8844",
"fax_number": "303-468-8850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 EMERSON ST",
"address_2": "#220",
"city": "DENVER",
"state": "CO",
"postal_code": "802181014",
"telephone_number": "303-468-8844",
"fax_number": "303-468-8850"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PARK AVENUE SURGERY CENTER LLC",
"organizational_subpart": "NO",
"enumeration_date": "2005-06-30",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "POPHAM",
"authorized_official_first_name": "JERRY",
"authorized_official_middle_name": "KIRK",
"authorized_official_title_or_position": "PHYSICIAN",
"authorized_official_telephone_number": "303-468-8844",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "261QA1903X",
"taxonomy_group": "",
"desc": "Clinic/Center, Ambulatory Surgical",
"state": "CO",
"license": "0471",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "0471",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.