Active NPI
Western Infectious Disease Infusion Center, Inc.
- Infectious Disease Physician
- Broomfield, CO
National Provider Identifier
1255733374
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Infectious Disease Physician
- Legal business name
- WESTERN INFECTIOUS DISEASE INFUSION CENTER, INC.
- Practice address
- 3303 W 144TH Ave
Suite 103
Broomfield, CO 80023-9464 - Phone
- (303) 425-9245
- Fax
- (303) 425-1378
- NPI assigned
- Sep 19, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jeffrey A. Desjardin, M.D.
- Title
- Physician/President
- Phone
- (303) 425-9245
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Infectious Disease Physician | 207RI0200X | Primary |
Addresses
Primary practice location
3303 W 144TH Ave
Suite 103
Broomfield, CO 80023-9464
Mailing address
PO Box 1449
Wheat Ridge, CO 80034-1449
Phone (303) 425-9245
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C377608 | Other | MEDICARE GROUP NUMBER |
National Provider Directory
National Provider Directory- Tax ID family
- Western Infectious Disease Infusion Center Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Infectious Disease Physician
- Longmont, CO
- NPI 1649927740
Locations
3303 W 144th Ave
Broomfield, CO 80023
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1411084800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1411084800000",
"number": "1255733374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1449",
"city": "WHEAT RIDGE",
"state": "CO",
"postal_code": "800341449",
"telephone_number": "303-425-9245",
"fax_number": "303-425-1378"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3303 W 144TH AVE",
"address_2": "SUITE 103",
"city": "BROOMFIELD",
"state": "CO",
"postal_code": "800239464",
"telephone_number": "303-425-9245",
"fax_number": "303-425-1378"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WESTERN INFECTIOUS DISEASE INFUSION CENTER, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2014-09-19",
"last_updated": "2014-09-19",
"status": "A",
"authorized_official_last_name": "DESJARDIN",
"authorized_official_first_name": "JEFFREY",
"authorized_official_middle_name": "A.",
"authorized_official_title_or_position": "PHYSICIAN/PRESIDENT",
"authorized_official_telephone_number": "303-425-9245",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207RI0200X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Infectious Disease",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP NUMBER",
"identifier": "C377608",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Broomfield, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.