NPIMap

Organization Active NPI

Keystone Primary Care LLC

  • Primary Care Clinic/Center
  • Aurora, CO
National Provider Identifier
1386261493
Registry record updated Dec 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
KEYSTONE PRIMARY CARE LLC
Doing business as
Keystone Primary Care
Practice address
11111 E Mississippi Ave Ste 112
Aurora, CO 80012-3106
Phone
(303) 755-5542
Fax
(720) 749-2121
NPI assigned
Jul 6, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2023

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

Authorized official

Name
Ms. Fatimah Aisha Johnson, AG-NP
Title
NP
Phone
(303) 755-5542

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

11111 E Mississippi Ave Ste 112
Aurora, CO 80012-3106

Mailing address

11111 E Mississippi Ave Ste 112
Aurora, CO 80012-3106
Phone (303) 755-5542

Other identifiers 3

IdentifierTypeStateIssuer
1871081737OtherCONPI
653232OtherMEDICARE
0993831OtherCONP LIC

Other names 1

  • Keystone Primary Care Doing business as

National Provider Directory

National Provider Directory

Locations

11111 E Mississippi Ave
Ste 112
Aurora, CO 80012
Phone (303) 755-5542

NPI Registry JSON

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

{
    "created_epoch": "1593993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703203200000",
    "number": "1386261493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11111 E MISSISSIPPI AVE STE 112",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800123106",
            "telephone_number": "303-755-5542",
            "fax_number": "720-749-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11111 E MISSISSIPPI AVE STE 112",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800123106",
            "telephone_number": "303-755-5542",
            "fax_number": "720-749-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-06",
        "last_updated": "2023-12-22",
        "certification_date": "2023-12-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "FATIMAH",
        "authorized_official_middle_name": "AISHA",
        "authorized_official_title_or_position": "NP",
        "authorized_official_telephone_number": "303-755-5542",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "AG-NP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1871081737",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "653232",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP LIC",
            "identifier": "0993831",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Keystone Primary Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Keystone Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.