Active NPI
Laurence F Gaynor, M.D
- Diagnostic Radiology Physician
- Englewood, CO
National Provider Identifier
1336126184
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 18133
- Practice address
- 501 E Hampden Ave
Englewood, CO 80113-2702 - Phone
- (303) 761-9190
- NPI assigned
- Dec 22, 2005
- Last updated
- Jul 7, 2014
- 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 |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 18133 | CO | Primary |
Addresses
Primary practice location
501 E Hampden Ave
Englewood, CO 80113-2702
Mailing address
10700 E Geddes Ave
No 200
Englewood, CO 80112-3800
Phone (303) 761-9190
Other identifiers 22
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 053216001 | Other | TX | TX MEDICAID |
| 01181338 | Medicaid | CO | |
| 200410090A | Medicaid | KS | |
| 300089928 | Other | CO | RR MCRE MIC |
| 100257090000 | Medicaid | NE | |
| 179782001 | Medicaid | AR | |
| 7617666 | Medicaid | NC | |
| 02555484 | Other | NY | NY MEDICAID |
| 1336126184 | Medicaid | IL | |
| 300049135 | Other | CO | RR MCRE RIA |
| 100017792 | Medicaid | WI | |
| 84-059792913 | Medicaid | NE | |
| 2316265 | Medicaid | LA | |
| XPY201227 | Other | CA | CA MEDICAID |
| 1336126184 | Medicaid | UT | |
| 7100227240 | Medicaid | KY | |
| 84073331 | Medicaid | NM | |
| 104686150 | Other | MI | MI MEDICAID |
| 1336126184 | Medicaid | WY | |
| 200424900A | Medicaid | OK | |
| 414545970A | Other | GA | GA MEDICAID |
| 922121 | Other | AZ | AZ MEDICAID |
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 |
|---|---|---|---|
| 17201 | CO | MD | Professional Counselor |
| 18133 | CO | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Diagnostic Imaging Associates | Diagnostic Radiology | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Diagnostic Radiology Physician
- Englewood, CO
- NPI 1447299425
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404691200000",
"number": "1336126184",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10700 E GEDDES AVE",
"address_2": "NO 200",
"city": "ENGLEWOOD",
"state": "CO",
"postal_code": "801123800",
"telephone_number": "303-761-9190",
"fax_number": "303-761-6278"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 E HAMPDEN AVE",
"city": "ENGLEWOOD",
"state": "CO",
"postal_code": "801132702",
"telephone_number": "303-761-9190"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAYNOR",
"first_name": "LAURENCE",
"middle_name": "F",
"name_prefix": "Dr.",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-22",
"last_updated": "2014-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "CO",
"license": "18133",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TX MEDICAID",
"identifier": "053216001",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01181338",
"state": "CO"
},
{
"code": "05",
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"issuer": null,
"identifier": "200410090A",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MCRE MIC",
"identifier": "300089928",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100257090000",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "179782001",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7617666",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NY MEDICAID",
"identifier": "02555484",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1336126184",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MCRE RIA",
"identifier": "300049135",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100017792",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "84-059792913",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2316265",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CA MEDICAID",
"identifier": "XPY201227",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1336126184",
"state": "UT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7100227240",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "84073331",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MI MEDICAID",
"identifier": "104686150",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1336126184",
"state": "WY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200424900A",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GA MEDICAID",
"identifier": "414545970A",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AZ MEDICAID",
"identifier": "922121",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Englewood, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.