NPIMap

Individual provider Active NPI

Arwen E Johnson

  • Family Medicine Physician
  • Denver, CO
National Provider Identifier
1164798583
Registry record updated May 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0054368 Issued in CO
Practice address
1783 15TH St
Denver, CO 80202-1888
Phone
(303) 532-1536
Fax
(978) 291-1875
NPI assigned
Mar 29, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X DR.0054368 CO Primary

Addresses

Primary practice location

1783 15TH St
Denver, CO 80202-1888

Mailing address

1783 15TH St
Denver, CO 80202-1888
Phone (303) 532-1536

Other identifiers 1

IdentifierTypeStateIssuer
25556215MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150716002236 CO Practitioner - Family Practice 8224269071 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Michigan Medical School, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

16951 E Quincy Ave
Uchmg Primary/Urgent Care Quincy
Aurora, CO 80015-1901
Phone (303) 752-5470

Hospital & facility affiliations

  • University of Colorado Hospital Authority Hospital, Aurora, CO, CCN 060024
  • Uchealth Highlands Ranch Hospital Hospital, Highlands Ranch, CO, CCN 060132
  • The Medical Center of Aurora & South Hospital Hospital, Aurora, CO, CCN 060100

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DR.0054368COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Jul 20, 2020 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Jul 20, 2020 Accepting new patients
Everside Health, LLC Family Medicine Past Accepting new patients

Locations

16951 E Quincy Ave
Aurora, CO 80015
Phone (303) 752-5470

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

9695 S Yosemite St
Ste 224UCHMG
Lone Tree, CO 80124
Phone (303) 265-3970

9695 S Yosemite St
Ste 224
Lone Tree, CO 80124
Phone (303) 265-3970

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

1000 W 8th Ave
Yuma, CO 80759
Phone (970) 345-6336

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.

Hospital & facility affiliations 39

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1332979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525651200000",
    "number": "1164798583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1783 15TH ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802021888",
            "telephone_number": "303-532-1536",
            "fax_number": "978-291-1875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1783 15TH ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802021888",
            "telephone_number": "303-532-1536",
            "fax_number": "978-291-1875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ARWEN",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-29",
        "last_updated": "2018-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0054368",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "25556215",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.