Individual provider Active NPI

Rhonda Detert Jeffries, MD

  • Pediatrics Physician
  • Greenwood Village, CO
National Provider Identifier
1184678286
Registry record updated Mar 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
DR.0054682 Issued in CO
Practice address
5600 S Quebec St
312A
Greenwood Village, CO 80111-2207
Phone
(303) 436-2727
Fax
(303) 426-2710
NPI assigned
May 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X DR.0054682 CO Primary

Addresses

Primary practice location

5600 S Quebec St
312A
Greenwood Village, CO 80111-2207

Mailing address

PO Box 3492
Frisco, CT 80443
Phone (678) 938-3900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070814000005 GA Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 7214934975 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0054682COMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Bortolazzo Group, LLC CurrentSince Mar 1, 2014 Accepting new patients
Emergency Coverage, LLC CurrentSince Jan 1, 2015 Accepting new patients
Morehouse Healthcare, Inc. Pediatrics PastSince Jul 1, 2012 Accepting new patients

Locations

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

1200 Memorial Dr
Dalton, GA 30720
Phone (706) 272-6115

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458864000000",
    "number": "1184678286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3492",
            "city": "FRISCO",
            "state": "CT",
            "postal_code": "80443",
            "telephone_number": "678-938-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 S QUEBEC ST",
            "address_2": "312A",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801112207",
            "telephone_number": "303-436-2727",
            "fax_number": "303-426-2710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFRIES",
        "first_name": "RHONDA",
        "middle_name": "DETERT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-22",
        "last_updated": "2016-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "DR.0054682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood Village, CO

Sources for this page

Verify at the official NPI Registry.