NPIMap

Organization Active NPI

Rivers Tribe Corp

Doing business as Omega Functional Health

  • Chiropractor
  • Wheat Ridge, CO
National Provider Identifier
1376069849
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHR.0007574 Issued in CO
Legal business name
RIVERS TRIBE CORP
Doing business as
Omega Functional Health
Practice address
6650 W 44TH Ave Ste 2B
Wheat Ridge, CO 80033-4711
Phone
(720) 667-3650
NPI assigned
Aug 16, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

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

Authorized official

Name
Samuel McDonald, DCNPI 1770001588
Title
Owner
Phone
(720) 667-3650

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CHR.0007574 CO Primary

Addresses

Primary practice location

6650 W 44TH Ave Ste 2B
Wheat Ridge, CO 80033-4711

Mailing address

PO Box 501
Arvada, CO 80001-0501
Phone (720) 667-3650

Other identifiers 2

IdentifierTypeStateIssuer
CHR.0007649OtherCOLICENSE NUMBER FOR LYNN TRAN
CHR.0007574OtherCOSTATE LICENSE NUMBER FOR SAMUEL MCDONALD

Other names 1

  • Omega Functional Health Doing business as

National Provider Directory

National Provider Directory

Locations

3333 Federal Blvd
Denver, CO 80211

6650 W 44th Ave
Ste 2B
Wheat Ridge, CO 80033
Phone (720) 667-3650

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1502841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702512000000",
    "number": "1376069849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 501",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800010501",
            "telephone_number": "720-667-3650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6650 W 44TH AVE STE 2B",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800334711",
            "telephone_number": "720-667-3650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERS TRIBE CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-16",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A",
        "authorized_official_last_name": "MCDONALD",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "720-667-3650",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "CHR.0007574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER FOR LYNN TRAN",
            "identifier": "CHR.0007649",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER FOR SAMUEL MCDONALD",
            "identifier": "CHR.0007574",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Omega Functional Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.