Active NPI
Larry Eric Frieder
- Chiropractor
- Boulder, CO
National Provider Identifier
1417998501
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CO3053
- Practice address
- 3400 Table Mesa Dr
#201
Boulder, CO 80305 - Phone
- (303) 494-0944
- Fax
- (303) 494-8678
- NPI assigned
- Jun 9, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CO3053 | CO | Primary |
Addresses
Primary practice location
3400 Table Mesa Dr
#201
Boulder, CO 80305
Mailing address
3400 Table Mesa Dr
#201
Boulder, CO 80305
Phone (303) 494-0944
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CO3053 | CO | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206921600000",
"number": "1417998501",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3400 TABLE MESA DR",
"address_2": "#201",
"city": "BOULDER",
"state": "CO",
"postal_code": "80305",
"telephone_number": "303-494-0944",
"fax_number": "303-494-8678"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 TABLE MESA DR",
"address_2": "#201",
"city": "BOULDER",
"state": "CO",
"postal_code": "80305",
"telephone_number": "303-494-0944",
"fax_number": "303-494-8678"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRIEDER",
"first_name": "LARRY",
"middle_name": "ERIC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-09",
"last_updated": "2008-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CO",
"license": "CO3053",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.