MSK Medical LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

License

38790 Issued in CO

Legal business name

MSK MEDICAL LLC

Practice address

1 Broadway
A-100
Denver, CO 80203-3959

Phone

(303) 455-6345

Fax

(303) 455-6343

NPI assigned

Apr 29, 2014

Organization subpart

No

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

Authorized official

Name

W Rafer Leach, M.D.

Title

Owner

Phone

(303) 870-8870

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1398729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398729600000",
    "number": "1275943201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BROADWAY",
            "address_2": "A-100",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802033959",
            "telephone_number": "303-455-6345",
            "fax_number": "303-455-6343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BROADWAY",
            "address_2": "A-100",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802033959",
            "telephone_number": "303-455-6345",
            "fax_number": "303-455-6343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MSK MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-29",
        "last_updated": "2014-04-29",
        "status": "A",
        "authorized_official_last_name": "LEACH",
        "authorized_official_first_name": "W",
        "authorized_official_middle_name": "RAFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-870-8870",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "CO",
            "license": "38790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Multi-Specialty Clinic/Center in Denver, CO
• Providers in Denver, CO by specialty
• Multi-Specialty Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.

Verify at the official NPI Registry.