NPIMap

Organization Active NPI

Platte Valley Medical Group, LLC

Doing business as Platte Valley Ortho Outreach Clinic at Larkridge

  • Orthopaedic Surgery Physician
  • Thornton, CO
National Provider Identifier
1487223269
Registry record updated Jun 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
PLATTE VALLEY MEDICAL GROUP, LLC
Doing business as
Platte Valley Ortho Outreach Clinic at Larkridge
Practice address
16570 Washington St
Thornton, CO 80023-8964
Phone
(303) 498-1885
Fax
(303) 498-1884
NPI assigned
Jun 24, 2021
Organization subpart
Yes
Parent organization
BRIGHTON COMMUNITY HOSPITAL ASSOCIATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 24, 2021

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

Authorized official

Name
Jon McDaniel
Title
VP Finance
Phone
(303) 272-0231

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

16570 Washington St
Thornton, CO 80023-8964

Mailing address

16570 Washington St
Thornton, CO 80023-8964
Phone (303) 498-1885

Other names 1

  • Platte Valley Ortho Outreach Clinic at Larkridge Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180112000840 CO Part B Supplier - Clinic/Group Practice 5890054100 Receives reassigned benefits from 201 practitioners
19 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Brighton, CO; Thornton, CO; Fort Lupton, CO; Denver, CO; Commerce City, CO

Other NPIs on the same Medicare enrollment 19

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 19

National Provider Directory

National Provider Directory
Part of
Brighton Comm

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

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": "1624492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624492800000",
    "number": "1487223269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16570 WASHINGTON ST",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "800238964",
            "telephone_number": "303-498-1885",
            "fax_number": "303-498-1884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16570 WASHINGTON ST",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "800238964",
            "telephone_number": "303-498-1885",
            "fax_number": "303-498-1884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLATTE VALLEY MEDICAL GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BRIGHTON COMMUNITY HOSPITAL ASSOCIATION",
        "enumeration_date": "2021-06-24",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A",
        "authorized_official_last_name": "MCDANIEL",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "303-272-0231"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Platte Valley Ortho Outreach Clinic at Larkridge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Thornton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.