NPIMap

Organization Active NPI

Boulder Biologics, LLC

  • Sports Medicine (Internal Medicine) Physician
  • Boulder, CO
National Provider Identifier
1477039907
Registry record updated May 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0010X
License
47816 Issued in CO
Legal business name
BOULDER BIOLOGICS, LLC
Doing business as
Boulder Biologics, LLC
Practice address
4745 Arapahoe Ave Ste 300
Boulder, CO 80303-1292
Phone
(720) 550-6175
NPI assigned
Jul 18, 2018
Last updated
May 28, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2020

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

Authorized official

Name
Dr. Jason Wells Glowney, MDNPI 1922264175
Title
President
Phone
(720) 550-6175

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Internal Medicine) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RS0010X 47816 CO Primary

Addresses

Primary practice location

4745 Arapahoe Ave Ste 300
Boulder, CO 80303-1292

Mailing address

4745 Arapahoe Ave Ste 300
Boulder, CO 80303-1292
Phone (720) 550-6175

Other names 1

  • Boulder Biologics, LLC Doing business as

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18118/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1531872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590624000000",
    "number": "1477039907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4745 ARAPAHOE AVE STE 300",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803031292",
            "telephone_number": "720-550-6175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4745 ARAPAHOE AVE STE 300",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803031292",
            "telephone_number": "720-550-6175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOULDER BIOLOGICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-18",
        "last_updated": "2020-05-28",
        "certification_date": "2020-05-28",
        "status": "A",
        "authorized_official_last_name": "GLOWNEY",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "WELLS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "720-550-6175",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RS0010X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Sports Medicine",
            "state": "CO",
            "license": "47816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boulder Biologics, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 28, 2020; 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.