Colorado Endosurgery Institute, P.C.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

44107 Issued in CO

Legal business name

COLORADO ENDOSURGERY INSTITUTE, P.C.

Practice address

16830 Northgate Dr
Suite 130
Parker, CO 80134-5778

Phone

(720) 290-8772

Fax

(720) 206-0806

NPI assigned

Feb 12, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Kevin Douglas Fradkin, M.D.

Title

Ceo and President

Phone

(720) 290-8772

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1202774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226620800000",
    "number": "1356519391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8390 E CRESCENT PKWY",
            "address_2": "SUITE 100",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801112811",
            "telephone_number": "720-290-8772",
            "fax_number": "720-206-0806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16830 NORTHGATE DR",
            "address_2": "SUITE 130",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801345778",
            "telephone_number": "720-290-8772",
            "fax_number": "720-206-0806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO ENDOSURGERY INSTITUTE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-12",
        "last_updated": "2008-11-14",
        "status": "A",
        "authorized_official_last_name": "FRADKIN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "CEO AND PRESIDENT",
        "authorized_official_telephone_number": "720-290-8772",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "CO",
            "license": "44107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Parker, CO
• Providers in Parker, CO by specialty
• Surgery Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.

Verify at the official NPI Registry.