NPIMap

Organization Active NPI

Archwell Health Professional Services of Colorado PC

  • Internal Medicine Physician
  • Arvada, CO
National Provider Identifier
1487485876
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ARCHWELL HEALTH PROFESSIONAL SERVICES OF COLORADO PC
Practice address
5017 W 64TH Ave
Arvada, CO 80003-6529
Phone
(303) 970-2334
NPI assigned
Aug 8, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

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

Authorized official

Name
Amy Moddesette
Title
Sr. Director, Managed Care Ops
Phone
(629) 224-1614

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

5017 W 64TH Ave
Arvada, CO 80003-6529

Mailing address

102 Woodmont Blvd Ste 600
Nashville, TN 37205-5250
Phone (888) 987-1151

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250627001969 CO Part B Supplier - Clinic/Group Practice 6002329653 Receives reassigned benefits from 21 practitioners
Practice locations: Arvada, CO; Englewood, CO; Aurora, CO

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D2318120Archwell Health5017 W 64TH Ave, Arvada, CO 80003Certificate of waiverFeb 4, 2027

National Provider Directory

National Provider Directory
Tax ID family
Archwell Health Professional Services of Colorado PC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5017 W 64th Ave
Arvada, CO 80003
Phone (303) 970-2334

Practitioners & affiliated clinicians

Practitioners 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1723075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777248000000",
    "number": "1487485876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 WOODMONT BLVD STE 600",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372055250",
            "telephone_number": "888-987-1151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5017 W 64TH AVE",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800036529",
            "telephone_number": "303-970-2334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARCHWELL HEALTH PROFESSIONAL SERVICES OF COLORADO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-08",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A",
        "authorized_official_last_name": "MODDESETTE",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "SR. DIRECTOR, MANAGED CARE OPS",
        "authorized_official_telephone_number": "629-224-1614"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arvada, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.