Active NPI
Mariellen McClory
- General Practice Physician
- Denver, CO
National Provider Identifier
1386853885
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 30020
- Practice address
- 2045 Franklin St
Denver, CO 80205-5437 - Phone
- (303) 764-4899
- NPI assigned
- May 21, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 30020 | CO | Primary |
Addresses
Primary practice location
2045 Franklin St
Denver, CO 80205-5437
Mailing address
10932 W Exposition Dr
Lakewood, CO 80226-3820
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30020 | CO | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1386853885",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10932 W EXPOSITION DR",
"city": "LAKEWOOD",
"state": "CO",
"postal_code": "802263820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2045 FRANKLIN ST",
"city": "DENVER",
"state": "CO",
"postal_code": "802055437",
"telephone_number": "303-764-4899"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCLORY",
"first_name": "MARIELLEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "CO",
"license": "30020",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Denver, 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.