Founders - Centura Medical Group LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

FOUNDERS - CENTURA MEDICAL GROUP LLC

Doing business as

Founders - Centura Medical Group LLC

Practice address

4386 Trail Boss Dr Ste a
Castle Rock, CO 80104-7512

Phone

(303) 688-8666

Fax

(303) 687-8260

NPI assigned

Apr 3, 2019

Last updated

Apr 3, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Angela Skinner

Title

Director Office of Medical Affairs

Phone

(303) 673-7175

Specialties & licenses 2

Addresses

Other names 1

• Founders - Centura Medical Group LLC Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Portercare Adventist Health System

  dba AdventHealth Hematology and Oncology Littleton

  • General Acute Care Hospital
  • Littleton, CO
  • NPI 1528608056

  Member Of

  NPD member

Locations

Practitioners 1

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.

• Anthony George Cerullo, PA-C

  • Medical Physician Assistant
  • Castle Rock, CO
  • NPI 1346271210
  NPD (past)

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

{
    "created_epoch": "1554249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554249600000",
    "number": "1396207767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 848349",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022848349",
            "telephone_number": "303-688-8666",
            "fax_number": "303-688-8260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4386 TRAIL BOSS DR STE A",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801047512",
            "telephone_number": "303-688-8666",
            "fax_number": "303-687-8260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNDERS - CENTURA MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-03",
        "last_updated": "2019-04-03",
        "status": "A",
        "authorized_official_last_name": "SKINNER",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "DIRECTOR OFFICE OF MEDICAL AFFAIRS",
        "authorized_official_telephone_number": "303-673-7175"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Founders - Centura Medical Group LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sara Rose Maria Foreman, RDN, CSSD
• Forevergreen Counseling PLLC
• Julie Formes, FNP
• Claude J Fortin, MD
• Kristen Marie Foster, MS OTR/L
• Founders Eyecare LLC
• Founders Eyecare LLC
• Founders Physical Therapy LLC
• Andrea Fox, RPH
• Kristin Marlena Frandsen, P.T.

• Family Medicine Physician in Castle Rock, CO
• Providers in Castle Rock, CO by specialty
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2019; 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.