Brian T. Shea DO LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

36013 Issued in CO

Legal business name

BRIAN T. SHEA DO LLC

Practice address

1790 30TH St
Suite 120
Boulder, CO 80301-1022

Phone

(303) 447-0022

NPI assigned

Oct 4, 2007

Last updated

Mar 4, 2008By 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

Brian T Shea, D.O.NPI 1396758835

Title

President

Phone

(303) 444-3443

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brian Thomas Shea, D.O.

  • Neuromusculoskeletal Medicine & OMM Physician
  • Boulder, CO
  • NPI 1396758835
  Medicare reassignment NPD Authorized official
• Ricardo Esparza, PH.D.

  • Clinical Psychologist
  • Boulder, CO
  • NPI 1427153055
  NPD (past)
• Mary Ann Keatley, PH.D.

  • Speech-Language Pathologist
  • Boulder, CO
  • NPI 1720035306
  NPD (past)
• Philip D Sutton, PH.D.

  • Psychologist
  • Boulder, CO
  • NPI 1376561555
  NPD (past)

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

{
    "created_epoch": "1191456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204588800000",
    "number": "1235327198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2086",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805222086",
            "telephone_number": "303-444-3443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1790 30TH ST",
            "address_2": "SUITE 120",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011022",
            "telephone_number": "303-447-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN T. SHEA DO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-04",
        "last_updated": "2008-03-04",
        "status": "A",
        "authorized_official_last_name": "SHEA",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "303-444-3443",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "36013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "92021328",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Debra Brenner
• Laura Bressler, LAC
• Brett Astor Counseling, PLLC
• Brian Kim LLC
• Brian P Gradisek DPM PLLC (Foot & Ankle Care of Boulder County)
• Karen J Bricken, LMFT
• Kristen Brickl
• Hannah Dustin Brickse, PA-C
• Madeleine Rose Bridge, RBT
• Brenda K Bridges, CNM

• Internal Medicine Physician in Boulder, CO
• Providers in Boulder, CO by specialty
• Internal Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.