Individual provider Active NPI

Susan E Ljunghag, M.D.

  • Obstetrics & Gynecology Physician
  • Lone Tree, CO
National Provider Identifier
1255486296
Registry record updated Jun 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
25658 Issued in CO
Practice address
10103 Ridgegate Parkway
Suite 200
Lone Tree, CO 80124-5525
Phone
(303) 788-6657
Fax
(303) 788-8837
NPI assigned
Jan 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 25658 CO
Obstetrics & Gynecology Physician 207V00000X 25658 CO Primary

Addresses

Primary practice location

10103 Ridgegate Parkway
Suite 200
Lone Tree, CO 80124-5525

Mailing address

4900 S Monaco St
Suite 210
Denver, CO 80237-3486
Phone (303) 788-6657

Other identifiers 2

IdentifierTypeStateIssuer
01256585MedicaidCO
160054944OtherCORAILROAD MEDICARE

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
25658COMDObstetrics & Gynecology Physician

Interoperability endpoints

  • Direct secure messaging: susan.ljunghag@hca3.eclinicaldirectplus.com

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464739200000",
    "number": "1255486296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 S MONACO ST",
            "address_2": "SUITE 210",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802373486",
            "telephone_number": "303-788-6657",
            "fax_number": "303-788-8837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10103 RIDGEGATE PARKWAY",
            "address_2": "SUITE 200",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801245525",
            "telephone_number": "303-788-6657",
            "fax_number": "303-788-8837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LJUNGHAG",
        "first_name": "SUSAN",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2016-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CO",
            "license": "25658",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CO",
            "license": "25658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01256585",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "160054944",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lone Tree, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2016; 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.