Individual provider Active NPI

Douglas Jay Dart, M.D.

  • Specialist
  • Wheat Ridge, CO
National Provider Identifier
1376657411
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
27383 Issued in CO
Practice address
3895 Upham St
Suite 201
Wheat Ridge, CO 80033-4651
Phone
(303) 487-0834
Fax
(303) 487-6932
NPI assigned
Aug 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 27383 CO Primary

Addresses

Primary practice location

3895 Upham St
Suite 201
Wheat Ridge, CO 80033-4651

Mailing address

3895 Upham St
Suite 201
Wheat Ridge, CO 80033-4651
Phone (303) 487-0834

Other identifiers 1

IdentifierTypeStateIssuer
01273838MedicaidCO

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
27383COMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376657411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3895 UPHAM ST",
            "address_2": "SUITE 201",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800334651",
            "telephone_number": "303-487-0834",
            "fax_number": "303-487-6932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3895 UPHAM ST",
            "address_2": "SUITE 201",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800334651",
            "telephone_number": "303-487-0834",
            "fax_number": "303-487-6932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DART",
        "first_name": "DOUGLAS",
        "middle_name": "JAY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CO",
            "license": "27383",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01273838",
            "state": "CO"
        }
    ],
    "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 Jul 8, 2007; 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.