Organization Active NPI

Smith Medical Direct Specialty Care Sugery Center of Denver PC

  • Surgery Physician
  • Littleton, CO
National Provider Identifier
1366218539
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
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, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 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 NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D2289596Smith Medical Direct Specialty Care8515 W Coal Mine Ave, Littleton, CO 80123Certificate of waiverSep 12, 2027

National Provider Directory

National Provider Directory

NPI 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.

Verify at the official NPI Registry.