Active NPI
James B Doody, PA-C
- Physician Assistant
- Thornton, CO
National Provider Identifier
1366606956
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1139
- Practice address
- 3260 E 104TH Ave
Thornton, CO 80233-4406 - Phone
- (720) 929-8300
- Fax
- (720) 929-8444
- NPI assigned
- Jul 14, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1139 | CO | Primary |
Addresses
Primary practice location
3260 E 104TH Ave
Thornton, CO 80233-4406
Mailing address
14090 W 48TH Ave
Golden, CO 80403-1779
Phone (303) 918-8866
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 99150735 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1139 | CO | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491350400000",
"number": "1366606956",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14090 W 48TH AVE",
"city": "GOLDEN",
"state": "CO",
"postal_code": "804031779",
"telephone_number": "303-918-8866",
"fax_number": "720-929-8444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3260 E 104TH AVE",
"city": "THORNTON",
"state": "CO",
"postal_code": "802334406",
"telephone_number": "720-929-8300",
"fax_number": "720-929-8444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOODY",
"first_name": "JAMES",
"middle_name": "B",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-14",
"last_updated": "2017-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CO",
"license": "1139",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "99150735",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Thornton, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.