South Denver Internal Medicine and Pediatrics, P.C.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

33478 Issued in CO

Legal business name

SOUTH DENVER INTERNAL MEDICINE AND PEDIATRICS, P.C.

Practice address

10103 Ridgegate Pkwy
Suite 114
Lone Tree, CO 80124-5520

Phone

(303) 799-8890

Fax

(303) 799-8891

NPI assigned

Mar 1, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Charles Miranda, M.D.NPI 1437112000

Title

President

Phone

(303) 799-8890

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charles Henry Miranda, MD

  • Internal Medicine Physician
  • Lone Tree, CO
  • NPI 1437112000
  Medicare reassignment NPD Authorized official
• Lisa Sue Smith, NP

  • Adult Health Nurse Practitioner
  • Denver, CO
  • NPI 1528151941
  NPD (past)
• Rhoda Yueh Chang, M.D.

  • Internal Medicine Physician
  • Cary, NC
  • NPI 1467427971
  NPD (past)

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265587200000",
    "number": "1376671628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10103 RIDGEGATE PKWY",
            "address_2": "SUITE 114",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801245520",
            "telephone_number": "303-799-8890",
            "fax_number": "303-799-8891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10103 RIDGEGATE PKWY",
            "address_2": "SUITE 114",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801245520",
            "telephone_number": "303-799-8890",
            "fax_number": "303-799-8891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH DENVER INTERNAL MEDICINE AND PEDIATRICS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2010-02-08",
        "status": "A",
        "authorized_official_last_name": "MIRANDA",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "303-799-8890",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CO",
            "license": "33478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa K Sorensen, ANP
• Neil Sorokin, PSYCHOLOGIST
• South Denver Acute Surgery PC
• South Denver Gastroenterology, PC
• South Denver Gastroenterology, PC
• Southeast Family Physicians
• Sowash Optometry Group, P.C.
• Carrie Sowell
• Nicolas A Spagnuolo, DC
• Spectrum Connections Therapy, PLLC.

• Primary Care Clinic/Center in Lone Tree, CO
• Providers in Lone Tree, CO by specialty
• Primary Care Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2010; 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.