NPIMap

Organization Active NPI

Medical Marijuana Doctor

  • Internal Medicine Physician
  • Aurora, CO
National Provider Identifier
1457683344
Registry record updated Feb 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MEDICAL MARIJUANA DOCTOR
Practice address
4745 S Helena Way
Aurora, CO 80015
Phone
(303) 995-1057
NPI assigned
Feb 3, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2010

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

Authorized official

Name
Mr. Gentry Reeves Dunlop Jr., MDNPI 1790805224
Title
Physician
Phone
(303) 995-1057

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

4745 S Helena Way
Aurora, CO 80015

Mailing address

4745 S Helena Way
Aurora, CO 80015
Phone (303) 995-1057

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1265155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265155200000",
    "number": "1457683344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4745 S HELENA WAY",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "80015",
            "telephone_number": "303-995-1057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4745 S HELENA WAY",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "80015",
            "telephone_number": "303-995-1057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL MARIJUANA DOCTOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-03",
        "last_updated": "2010-02-03",
        "status": "A",
        "authorized_official_last_name": "DUNLOP",
        "authorized_official_first_name": "GENTRY",
        "authorized_official_middle_name": "REEVES",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "303-995-1057",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Feb 3, 2010; 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.