Organization Active NPI

PHNX LLC

  • Family Medicine Physician
  • Boulder, CO
National Provider Identifier
1427995455
Registry record updated Apr 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PHNX LLC
Practice address
1810 30TH St Ste B
Boulder, CO 80301-1025
Phone
(303) 442-7473
NPI assigned
Apr 29, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2026

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

Authorized official

Name
Alicia Moreno
Title
Ceo
Phone
(832) 725-8685

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1810 30TH St Ste B
Boulder, CO 80301-1025

Mailing address

1810 30TH St Ste B
Boulder, CO 80301-1025
Phone (303) 442-7473

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1777420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777420800000",
    "number": "1427995455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 30TH ST STE B",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011025",
            "telephone_number": "303-442-7473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 30TH ST STE B",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011025",
            "telephone_number": "303-442-7473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHNX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-29",
        "last_updated": "2026-04-29",
        "certification_date": "2026-04-29",
        "status": "A",
        "authorized_official_last_name": "MORENO",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "832-725-8685"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "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 Apr 29, 2026; 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.