Stadium Medical, Inc.

Primary specialty

AmbulanceTaxonomy code 341600000X

Legal business name

STADIUM MEDICAL, INC.

Practice address

695 Canosa CT
Denver, CO 80204-4143

Phone

(720) 630-2000

NPI assigned

Jun 20, 2008

Organization subpart

No

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

Authorized official

Name

Bernie Ames

Title

Administrative Specialist

Phone

(303) 549-7916

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Locations

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

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624492800000",
    "number": "1316108459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "695 CANOSA CT",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044143",
            "telephone_number": "720-630-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "695 CANOSA CT",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044143",
            "telephone_number": "720-630-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STADIUM MEDICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-20",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A",
        "authorized_official_last_name": "AMES",
        "authorized_official_first_name": "BERNIE",
        "authorized_official_title_or_position": "ADMINISTRATIVE SPECIALIST",
        "authorized_official_telephone_number": "303-549-7916"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "CO",
            "license": "06-7429",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12959049",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ambulance in Denver, CO
• Providers in Denver, CO by specialty
• Ambulance in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.