Theodore R Villavicencio, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

31320 Issued in CO

Practice address

10791 Kitty Dr
Suite a
Conifer, CO 80433

Phone

(303) 838-4686

Fax

(303) 816-4905

NPI assigned

May 22, 2006

Last updated

Nov 9, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

University of Colorado School of Medicine, Denver, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

American Current Care PAGroup PAC ID 9739260019, 545 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• American Current Care PA

  dba Concentra Urgent Care

  • Urgent Care Clinic/Center
  • Addison, TX
  • NPI 1811178213

  CO

  Medicare reassignment Care Compare group NPD
• American Current Care P.a.

  dba Concentra Urgent Care

  • Urgent Care Clinic/Center
  • Beaumont, TX
  • NPI 1376356568
  NPD

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320796800000",
    "number": "1366496366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10791 KITTY DR",
            "address_2": "SUITE A",
            "city": "CONIFER",
            "state": "CO",
            "postal_code": "80433",
            "telephone_number": "303-838-4686",
            "fax_number": "303-816-4905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10791 KITTY DR",
            "address_2": "SUITE A",
            "city": "CONIFER",
            "state": "CO",
            "postal_code": "80433",
            "telephone_number": "303-838-4686",
            "fax_number": "303-816-4905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLAVICENCIO",
        "first_name": "THEODORE",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2011-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "31320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terence A Trinka I, O.D. CN
• Carol Anne Turner, M.D.
• Amber Lane Van Treeck, MA, LPC
• Alyssa Vankeulen, DPT
• Tracy Vermillion-Horn
• Kaylyn Vonglahn, PA
• Michelle Waller, PA
• Adrian Jean Walsh, MSN, RN, FNP-C
• Warrior Tree Counseling, LLC
• Warrior Tree Counseling, LLC

• Family Medicine Physician in Conifer, CO
• Providers in Conifer, CO by specialty
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.