Individual provider Active NPI

Rollin Vaughn Oden, MD

  • Family Medicine Physician
  • Denver, CO
National Provider Identifier
1245209147
Registry record updated Jun 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0056337 Issued in CO
Practice address
2130 Stout St
Denver, CO 80205-2827
Phone
(303) 293-2220
NPI assigned
Mar 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) Physician 207QA0401X DR.0056337 CO
Family Medicine Physician 207Q00000X DR.0056337 CO Primary

Addresses

Primary practice location

2130 Stout St
Denver, CO 80205-2827

Mailing address

2111 Champa St
Denver, CO 80205-2529
Phone (303) 293-2220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20181016000336 CO Order and Referring Only - Family PracticePractitioner - Family Practice 0345396610

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, San Diego School of Medicine, 1982
Medicare assignment
May accept Medicare assignment
Group practices
Colorado Coalition for the HomelessGroup PAC ID 7618958687, shared by 8 NPIs, 47 clinicians

Practice addresses (Care Compare)

2130 Stout St
Denver, CO 80205-2827
Phone (303) 293-2220

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0056337COMDAddiction Medicine (Family Medicine) Physician

NPI Registry JSON

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1245209147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 CHAMPA ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802052529",
            "telephone_number": "303-293-2220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 STOUT ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802052827",
            "telephone_number": "303-293-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODEN",
        "first_name": "ROLLIN",
        "middle_name": "VAUGHN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-15",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "CO",
            "license": "DR.0056337",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0056337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.