Organization Active NPI

Denver Retina Center PC

  • Ophthalmology Physician
  • Denver, CO
National Provider Identifier
1164608261
Registry record updated Mar 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
43717 Issued in CO
Legal business name
DENVER RETINA CENTER PC
Practice address
4500 Cherry Creek Dr. S
Suite 102
Denver, CO 80246
Phone
(303) 220-0393
Fax
(303) 740-5865
NPI assigned
Jan 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2011

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

Authorized official

Name
Dr. Diana ReevesNPI 1386625044
Title
Owner
Phone
(303) 886-6282

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)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 43717 CO Primary

Addresses

Primary practice location

4500 Cherry Creek Dr. S
Suite 102
Denver, CO 80246

Mailing address

PO Box 461009
Denver, CO 80246-5009
Phone (303) 220-0393

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080307000034 CO Part B Supplier - Clinic/Group Practice 7618052259 Receives reassigned benefits from 1 practitioner
Practice locations: Denver, CO

National Provider Directory

National Provider Directory

Locations

4500 E Cherry Creek South Dr
Ste 102
Denver, CO 80246
Phone (303) 220-0393

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1200614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299715200000",
    "number": "1164608261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 461009",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802465009",
            "telephone_number": "303-220-0393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 CHERRY CREEK DR. S",
            "address_2": "SUITE 102",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80246",
            "telephone_number": "303-220-0393",
            "fax_number": "303-740-5865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENVER RETINA CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-18",
        "last_updated": "2011-03-10",
        "status": "A",
        "authorized_official_last_name": "REEVES",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-886-6282",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "CO",
            "license": "43717",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Mar 10, 2011; 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.