Active NPI
Thomas Neil Chisholm, M.D.
- Family Medicine Physician
- Denver, CO
National Provider Identifier
1306846688
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 25364
- Practice address
- 3540 S Poplar St
Suite 200
Denver, CO 80237-1362 - Phone
- (303) 226-0013
- Fax
- (303) 757-6148
- NPI assigned
- Jul 28, 2005
- Last updated
- Feb 20, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 25364 | CO | Primary |
Addresses
Primary practice location
3540 S Poplar St
Suite 200
Denver, CO 80237-1362
Mailing address
3540 S Poplar St
Suite 200
Denver, CO 80237-1362
Phone (303) 226-0013
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 870689258002 | Other | CO | ROCKY MOUNTAIN HMO ID |
| 29599 | Other | CO | ANTHEM BC/BS PROVIDER ID |
| 870689258002 | Other | CO | PACIFICARE HMO ID |
| 01253640 | Medicaid | CO | |
| 4137337 | Other | CO | AETNA HMO PROVIDER ID |
| P00064924 | Other | CO | MEDICARE RAIL ROAD ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25364 | CO | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203465600000",
"number": "1306846688",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3540 S POPLAR ST",
"address_2": "SUITE 200",
"city": "DENVER",
"state": "CO",
"postal_code": "802371362",
"telephone_number": "303-226-0013",
"fax_number": "303-757-6148"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3540 S POPLAR ST",
"address_2": "SUITE 200",
"city": "DENVER",
"state": "CO",
"postal_code": "802371362",
"telephone_number": "303-226-0013",
"fax_number": "303-757-6148"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHISHOLM",
"first_name": "THOMAS",
"middle_name": "NEIL",
"name_prefix": "Mr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-28",
"last_updated": "2008-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CO",
"license": "25364",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ROCKY MOUNTAIN HMO ID",
"identifier": "870689258002",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BC/BS PROVIDER ID",
"identifier": "29599",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PACIFICARE HMO ID",
"identifier": "870689258002",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01253640",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO PROVIDER ID",
"identifier": "4137337",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAIL ROAD ID",
"identifier": "P00064924",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.