Individual provider Active NPI

Roderick Shields O'Brien, M.D.

  • Psychiatry Physician
  • Louisville, CO
National Provider Identifier
1487686325
Registry record updated Feb 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
0051727 Issued in CO
Practice address
2255 S 88TH St
Louisville, CO 80027-9716
Phone
(303) 673-9990
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 0051727 CO
Psychiatry Physician 2084P0800X 0051727 CO Primary

Addresses

Primary practice location

2255 S 88TH St
Louisville, CO 80027-9716

Mailing address

2255 S 88TH St
Louisville, CO 80027-9716
Phone (303) 673-9990

Other practice location 1

1750 E Ken Pratt Blvd Fl 1
Longmont, CO 80504-5311
Phone (720) 718-8310

Other identifiers 1

IdentifierTypeStateIssuer
1487686325MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130214000336 CO Practitioner - PsychiatryPractitioner - Neurology 8224282504 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Neurology
Education
Indiana University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Chriesl Infusion Centers LLCGroup PAC ID 4183048754, 14 clinicians
Uhs of Centennial Peaks LLCGroup PAC ID 6204987621, 5 clinicians

Practice addresses (Care Compare)

1444 S Potomac St
Suite 220
Aurora, CO 80012-4509
Phone (720) 400-7025

2255 S 88TH St
Louisville, CO 80027-9716
Phone (303) 673-9990

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0051727COMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Uhs of Centennial Peaks LLC CurrentSince Aug 1, 2014 Accepting new patients
Uhs of Centennial Peaks, LLC CurrentSince Aug 1, 2014 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Mar 6, 2022 Accepting new patients
Poudre Valley Medical Group, LLC Current Accepting new patients
TMS Solutions Inc Neurology CurrentSince Nov 18, 2019 Accepting new patients
Noma, PC Past Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

425 S Cherry St
Ste 906
Glendale, CO 80246
Phone (303) 500-3055

3150 N 12th St
Grand Junction, CO 81506
Phone (970) 243-5437

5655 S Yosemite St
Ste 201
Greenwood Village, CO 80111

1760 E Ken Pratt Blvd
Ste 305
Longmont, CO 80504
Phone (720) 718-8310

1750 E Ken Pratt Blvd
Fl 1
Longmont, CO 80504
Phone (720) 718-8310

1750 E Ken Pratt Blvd
Unit 1
Longmont, CO 80504

2255 S 88th St
Louisville, CO 80027
Phone (303) 666-2095

765 E Holland Ave
Ste 1
Spokane, WA 99218
Phone (509) 242-6005

Interoperability endpoints

  • Direct secure messaging: roderick.o.brien.1@21564.direct.athenahealth.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1487686325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2255 S 88TH ST",
            "city": "LOUISVILLE",
            "state": "CO",
            "postal_code": "800279716",
            "telephone_number": "303-673-9990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 S 88TH ST",
            "city": "LOUISVILLE",
            "state": "CO",
            "postal_code": "800279716",
            "telephone_number": "303-673-9990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1750 E Ken Pratt Blvd Fl 1",
            "address_purpose": "LOCATION",
            "city": "Longmont",
            "state": "CO",
            "postal_code": "805045311",
            "country_code": "US",
            "telephone_number": "720-718-8310",
            "fax_number": "720-718-8301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "RODERICK",
        "middle_name": "SHIELDS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CO",
            "license": "0051727",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "0051727",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1487686325",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, CO

Sources for this page

Verify at the official NPI Registry.