Wheat Ridge Family Physicians LLC
Organization Active NPI Family Medicine Physician · Denver, CO
NPI 1164574562 · NPPES record last updated Sep 20, 2013
Key facts
- NPI
- 1164574562
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- WHEAT RIDGE FAMILY PHYSICIANS LLC
- Practice address
- 4500 W 38TH Ave
Suite 220
Denver, CO 80212 - Phone
- (303) 420-1297
- Fax
- (303) 420-2953
- NPI assigned
- Jan 17, 2007
- Organization subpart
- No
Authorized official
- Name
- Wendy Garduno
- Title
- Office Manager
- Phone
- (303) 420-1297
Practitioners 10
-
Joseph T Bednarek, M.D.
-
Anna Johanson, MD
-
Lukas McWhorter, M.D.
-
Blaine M Olsen, MD
-
Maura E Hinton, PA-C
-
Lauren Leigh Kolfenbach, PA-C
-
Dien Truy Le, O.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040914001379 | CO | Part B Supplier - Clinic/Group Practice | 0547237919 |
Receives reassigned benefits from 9 practitioners Practice locations: Denver, CO |
National Provider Directory
Locations
5000 Quitman St
Denver, CO 80212
6990 W 38th Ave
Ste 302
Wheat Ridge, CO 80033
Phone (303) 420-1297
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
4500 W 38TH Ave
Suite 220
Denver, CO 80212
Mailing address
4500 W 38TH Ave
Suite 220
Denver, CO 80212
Phone (303) 420-1297
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 08550573 | Medicaid | CO |
Other names
- Highlands Family Medicine
Other providers in Denver, CO
- Krystyn Whaley
- Courtney Wham
- Morgan Mary Wharton
- What If You Fly Counseling Services PLLC
- WHC Den, LLC
- Wheat Ridge Regional Center
- Wheat Ridge Regional Center
- Suzanne Wheatley Carrano
- Erin Wheatley
- Amanda Wheeler
All providers in Denver, CO · Family Medicine Physician in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 20, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.