Donna L Ackerman, D.O.

Key facts

NPI

1295728467

Entity type

Individual (NPI type 1)

Primary specialty

Pediatrics Physician 208000000X

License

32553 (CO)

Practice address

3260 E 104TH Ave
Thornton, CO 80233-4406

Phone

(720) 929-8300

Fax

(720) 929-8444

NPI assigned

Aug 23, 2005

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Doctor of Osteopathy

State licenses

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 6, 2017.

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483660800000",
    "number": "1295728467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 S YOSEMITE ST",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801121406",
            "telephone_number": "303-773-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3260 E 104TH AVE",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802334406",
            "telephone_number": "720-929-8300",
            "fax_number": "720-929-8444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACKERMAN",
        "first_name": "DONNA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-23",
        "last_updated": "2017-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "32553",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01235539",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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