Modern Vascular of Denver, LLC

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

Legal business name

MODERN VASCULAR OF DENVER, LLC

Practice address

9441 Huron St
Thornton, CO 80260-5426

Phone

(720) 617-7333

Fax

(720) 627-8845

NPI assigned

Aug 8, 2019

Last updated

Jan 10, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Yury Gampel

Title

Manager

Phone

(818) 880-8605

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1565222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578614400000",
    "number": "1184279804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26500 AGOURA RD STE 201",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913023556",
            "telephone_number": "818-880-8605",
            "fax_number": "818-579-7916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9441 HURON ST",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802605426",
            "telephone_number": "720-617-7333",
            "fax_number": "720-627-8845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN VASCULAR OF DENVER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-08",
        "last_updated": "2020-01-10",
        "certification_date": "2020-01-10",
        "status": "A",
        "authorized_official_last_name": "GAMPEL",
        "authorized_official_first_name": "YURY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "818-880-8605"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2471V0106X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Vascular-Interventional Technology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.

Verify at the official NPI Registry.