Individual provider Active NPI

Mary Cain, P.A.C

  • Physician Assistant
  • Littleton, CO
National Provider Identifier
1215939095
Registry record updated Sep 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
951 Issued in CO
Practice address
7780 S Broadway
Suite #150
Littleton, CO 80122-2648
Phone
(303) 795-5980
Fax
(303) 795-7881
NPI assigned
Aug 11, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 951 CO Primary

Addresses

Primary practice location

7780 S Broadway
Suite #150
Littleton, CO 80122-2648

Mailing address

3853 S Nelson CT
Denver, CO 80235-1150
Phone (303) 795-5980

Other identifiers 1

IdentifierTypeStateIssuer
08103054MedicaidCO

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
Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220832000000",
    "number": "1215939095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3853 S NELSON CT",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802351150",
            "telephone_number": "303-795-5980",
            "fax_number": "303-795-7881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7780 S BROADWAY",
            "address_2": "SUITE #150",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801222648",
            "telephone_number": "303-795-5980",
            "fax_number": "303-795-7881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAIN",
        "first_name": "MARY",
        "credential": "P.A.C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-11",
        "last_updated": "2008-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "951",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08103054",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Littleton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2008; 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.