Organization Active NPI

Eagle Ridge Medical Inc

  • Family Medicine Physician
  • Brighton, CO
National Provider Identifier
1275876112
Registry record updated Mar 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
EAGLE RIDGE MEDICAL INC
Practice address
1606 Prairie Center Pkwy
Ste 240
Brighton, CO 80601-4004
Phone
(303) 659-1152
Fax
(720) 685-0027
NPI assigned
Mar 28, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2013

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

Authorized official

Name
Brad Davis
Title
Director Physicians Groups
Phone
(303) 498-3010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1606 Prairie Center Pkwy
Ste 240
Brighton, CO 80601-4004

Mailing address

1606 Prairie Center Pkwy
Ste 240
Brighton, CO 80601-4004
Phone (303) 659-1152

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1364428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364428800000",
    "number": "1275876112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1606 PRAIRIE CENTER PKWY",
            "address_2": "STE 240",
            "city": "BRIGHTON",
            "state": "CO",
            "postal_code": "806014004",
            "telephone_number": "303-659-1152",
            "fax_number": "720-685-0027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1606 PRAIRIE CENTER PKWY",
            "address_2": "STE 240",
            "city": "BRIGHTON",
            "state": "CO",
            "postal_code": "806014004",
            "telephone_number": "303-659-1152",
            "fax_number": "720-685-0027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE RIDGE MEDICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-28",
        "last_updated": "2013-03-28",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "DIRECTOR PHYSICIANS GROUPS",
        "authorized_official_telephone_number": "303-498-3010"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2013; 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.