Active NPI
Smith Medical Direct Specialty Care Sugery Center of Denver PC
- Surgery Physician
- Littleton, CO
National Provider Identifier
1366218539
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- Legal business name
- SMITH MEDICAL DIRECT SPECIALTY CARE SUGERY CENTER OF DENVER PC
- Practice address
- 8515 W Coal Mine Ave Ste 240
Littleton, CO 80123-4429 - Phone
- (720) 912-8289
- Fax
- (720) 677-1193
- NPI assigned
- Nov 29, 2023
- Last updated
- Nov 29, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lisa Fagan
- Title
- Ceo
- Phone
- (720) 912-8289
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | Primary |
Addresses
Primary practice location
8515 W Coal Mine Ave Ste 240
Littleton, CO 80123-4429
Mailing address
8515 W Coal Mine Ave Ste 240
Littleton, CO 80123-4429
Phone (720) 912-8289
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 06D2289596 | Smith Medical Direct Specialty Care | Certificate of waiver | Sep 12, 2027 |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1701216000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1701216000000",
"number": "1366218539",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8515 W COAL MINE AVE STE 240",
"city": "LITTLETON",
"state": "CO",
"postal_code": "801234429",
"telephone_number": "720-912-8289",
"fax_number": "720-677-1193"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8515 W COAL MINE AVE STE 240",
"city": "LITTLETON",
"state": "CO",
"postal_code": "801234429",
"telephone_number": "720-912-8289",
"fax_number": "720-677-1193"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SMITH MEDICAL DIRECT SPECIALTY CARE SUGERY CENTER OF DENVER PC",
"organizational_subpart": "NO",
"enumeration_date": "2023-11-29",
"last_updated": "2023-11-29",
"certification_date": "2023-11-29",
"status": "A",
"authorized_official_last_name": "FAGAN",
"authorized_official_first_name": "LISA",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "720-912-8289"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Surgery",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Littleton, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.