Individual provider Active NPI

John R Steinbaugh, M.D.

  • Dermatology Physician
  • Boulder, CO
National Provider Identifier
1184699159
Registry record updated Mar 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
20521 Issued in CO
Practice address
3575 Broadway St
Boulder, CO 80304-1825
Phone
(303) 449-0933
Fax
(303) 447-0794
NPI assigned
Feb 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 20521 CO Primary
MOHS-Micrographic Surgery Physician 207ND0101X 20521 CO

Addresses

Primary practice location

3575 Broadway St
Boulder, CO 80304-1825

Mailing address

1075 Linden Ave
Boulder, CO 80304-0726
Phone (303) 449-0933

Other identifiers 1

IdentifierTypeStateIssuer
01205210MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20521COMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364428800000",
    "number": "1184699159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 LINDEN AVE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803040726",
            "telephone_number": "303-449-0933",
            "fax_number": "303-447-0794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3575 BROADWAY ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803041825",
            "telephone_number": "303-449-0933",
            "fax_number": "303-447-0794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEINBAUGH",
        "first_name": "JOHN",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2013-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CO",
            "license": "20521",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CO",
            "license": "20521",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01205210",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2013; 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.