Organization Active NPI

Preferred Provider Services, LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Aurora, CO
National Provider Identifier
1275813297
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
PREFERRED PROVIDER SERVICES, LLC
Practice address
3025 S Parker Rd
Suite 100
Aurora, CO 80014-2911
Phone
(303) 481-7030
Fax
(303) 745-7665
NPI assigned
Aug 22, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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

Authorized official

Name
Lola Edwards, RN
Title
President
Phone
(033) 481-7030

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0300X Primary

Addresses

Primary practice location

3025 S Parker Rd
Suite 100
Aurora, CO 80014-2911

Mailing address

3025 S Parker Rd
Suite 100
Aurora, CO 80014-2911
Phone (303) 481-7030

Other identifiers 1

IdentifierTypeStateIssuer
01789759MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120608000291 CO Part B Supplier - Clinic/Group Practice 1951565647 Receives reassigned benefits from 7 practitioners
Practice locations: Aurora, CO

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D2049375Preferred Provider Services, LLC3025 S Parker Rd Ste 100, Aurora, CO 80014Certificate of waiverNov 4, 2026

National Provider Directory

National Provider Directory

Locations

3025 S Parker Rd
Ste 100
Aurora, CO 80014
Phone (303) 481-7030

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1313971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737676800000",
    "number": "1275813297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3025 S PARKER RD",
            "address_2": "SUITE 100",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800142911",
            "telephone_number": "303-481-7030",
            "fax_number": "303-745-7665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3025 S PARKER RD",
            "address_2": "SUITE 100",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800142911",
            "telephone_number": "303-481-7030",
            "fax_number": "303-745-7665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREFERRED PROVIDER SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-22",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "LOLA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "033-481-7030",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01789759",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.