Identity Hormones Co LLC

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

Legal business name

IDENTITY HORMONES CO LLC

Practice address

7305 E 29TH Ave Ste 220
Denver, CO 80238-2701

Phone

(602) 354-3925

NPI assigned

Sep 5, 2023

Organization subpart

No

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

Authorized official

Name

Teah Phillips

Title

Credentialing Manager

Phone

(901) 205-3999

Specialties & licenses 1

Addresses

Other names 1

• Identity Hormones Denver Doing business as

Locations

Practitioners 1

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

• Katie P Rudofsky, FNP-C

  • Family Nurse Practitioner
  • Denver, CO
  • NPI 1154710200
  NPD (past)

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

{
    "created_epoch": "1693872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699833600000",
    "number": "1174309231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7305 E 29TH AVE STE 220",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802382701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7305 E 29TH AVE STE 220",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802382701",
            "telephone_number": "602-354-3925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDENTITY HORMONES CO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-05",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "TEAH",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "901-205-3999"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Identity Hormones Denver",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Identity Hormones Denver",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Icon Dental
• Therese Ann Ida, R.D.
• Idea Forum Inc.
• Ideal Dental PLLC
• Chelsea Marie Ideker, MSOTR/L
• Ies Colorado PLLC
• Ies Obs Colorado PLLC
• Cristos Ifantides, M.D.
• Natalie Ignatieff, D.D.S.
• Robyn Ignatowski, PT, DPT

• Adult Medicine Physician in Denver, CO
• Providers in Denver, CO by specialty
• Adult Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.