Individual provider Active NPI

Gary James Cantrell Jr., D.O

  • Family Medicine Physician
  • Denver, CO
National Provider Identifier
1245686674
Registry record updated Apr 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0062666 Issued in CO
Practice address
400 S Colorado Blvd Ste 900
Denver, CO 80246-1241
Phone
(303) 318-3520
NPI assigned
May 4, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DR.0062666 CO Primary

Addresses

Primary practice location

400 S Colorado Blvd Ste 900
Denver, CO 80246-1241

Mailing address

400 S Colorado Blvd Ste 900
Denver, CO 80246-1241
Phone (303) 318-3520

Other practice location 1

3700 S Main St
Blacksburg, VA 24060-7017
Phone (540) 953-3528

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
I20190729000469 CO Practitioner - Family Practice 6406141126 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Intermountain Medical Group Denver LLCGroup PAC ID 0840513552, 571 clinicians

Practice addresses (Care Compare)

Broomfield, CO 80021
Phone (720) 807-4461

8350 Colorado Blvd
Unit 160
Firestone, CO 80504-6803
Phone (303) 673-1370

Hospital & facility affiliations

  • Saint Joseph Hospital Hospital, Denver, CO, CCN 060028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0062666COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Uptown Community Health Center Inc Family Medicine Current Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Oct 19, 2020 Accepting new patients
Uptown Community Health Center Inc CurrentSince Nov 15, 2022 Accepting new patients
Intermountain Medical Group Denver, LLC Family Medicine Current Accepting new patients
Uptown Community Health Center Inc CurrentSince Nov 15, 2022 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Oct 19, 2020 Accepting new patients
Uptown Community Health Center Inc Past Accepting new patients

Locations

1960 N Ogden St
Ste 460
Denver, CO 80218
Phone (303) 318-2500

400 S Colorado Blvd
Ste 900
Denver, CO 80246
Phone (303) 318-3520

1960 N Ogden St
Ste 330
Denver, CO 80218
Phone (303) 318-2610

Interoperability endpoints

  • Direct secure messaging: gary.cantrell@hca6.eclinicaldirectplus.com

Organizations & group practices 7

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1462320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649894400000",
    "number": "1245686674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S COLORADO BLVD STE 900",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802461241",
            "telephone_number": "303-318-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S COLORADO BLVD STE 900",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802461241",
            "telephone_number": "303-318-3520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3700 S Main St",
            "address_purpose": "LOCATION",
            "city": "Blacksburg",
            "state": "VA",
            "postal_code": "240607017",
            "country_code": "US",
            "telephone_number": "540-953-3528",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANTRELL",
        "first_name": "GARY",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.O",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-04",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0062666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.