Individual provider Active NPI

Larry D Underwood, MD

  • Ophthalmology Physician
  • Wheat Ridge, CO
National Provider Identifier
1366439838
Registry record updated Oct 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
20049 Issued in CO
Practice address
7920 W 44TH Ave
Wheat Ridge, CO 80033-4506
Phone
(303) 424-3206
Fax
(303) 940-1099
NPI assigned
Sep 30, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 20049 CO Primary

Addresses

Primary practice location

7920 W 44TH Ave
Wheat Ridge, CO 80033-4506

Mailing address

7920 W 44TH Ave
Wheat Ridge, CO 80033-4506
Phone (303) 424-3206

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040709000828 CO Practitioner - Ophthalmology 1153309885 Practice locations: Wheat Ridge, CO

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
20049COMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Larry D Underwood MD Ophthalmology PastSince Jan 1, 1994 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254787200000",
    "number": "1366439838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7920 W 44TH AVE",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800334506",
            "telephone_number": "303-424-3206",
            "fax_number": "303-940-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7920 W 44TH AVE",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800334506",
            "telephone_number": "303-424-3206",
            "fax_number": "303-940-1099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNDERWOOD",
        "first_name": "LARRY",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2009-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CO",
            "license": "20049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheat Ridge, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2009; 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.