Woodland Park Family Medicine, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

43176 Issued in CO

Legal business name

WOODLAND PARK FAMILY MEDICINE, LLC

Practice address

16222 W US Highway 24
Ste 200
Woodland Park, CO 80863-8762

Phone

(719) 686-2801

Fax

(719) 686-2809

NPI assigned

Jun 1, 2007

Last updated

Aug 6, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Matthew C Young, M.D.

Title

Partner Physician

Phone

(719) 686-2801

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 3

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.

• Christine A. Carroll

  • Physician Assistant
  • Lone Tree, CO
  • NPI 1891004594
  NPD (past)
• Patrick D Devanny, MD

  • Orthopaedic Hand Surgery Physician
  • Colorado Springs, CO
  • NPI 1902881931
  NPD (past)
• Natalie Marie Bernys, PA-C

  • Physician Assistant
  • Annandale, VA
  • NPI 1104159425
  NPD (past)

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217980800000",
    "number": "1487856407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16222 W US HIGHWAY 24",
            "address_2": "SUITE 200",
            "city": "WOODLAND PARK",
            "state": "CO",
            "postal_code": "808638762",
            "telephone_number": "719-686-2801",
            "fax_number": "719-686-2809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16222 W US HIGHWAY 24",
            "address_2": "STE 200",
            "city": "WOODLAND PARK",
            "state": "CO",
            "postal_code": "808638762",
            "telephone_number": "719-686-2801",
            "fax_number": "719-686-2809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODLAND PARK FAMILY MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-01",
        "last_updated": "2008-08-06",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PARTNER PHYSICIAN",
        "authorized_official_telephone_number": "719-686-2801",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "43176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "810093",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41134711",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Woodland Park Ambulance
• Woodland Park Anesthesia LLC
• Woodland Park Dental Professional LLC
• Woodland Park Emergency Physicians PLLC
• Woodland Park Family Medicine
• Woodland Park Pediatric Dentistry
• Woodland Park School District Re2
• Woodland Park Surgical Associates, P.C.
• Woodland Urgent Care, LLC
• Wpo, PLLC

• Family Medicine Physician in Woodland Park, CO
• Providers in Woodland Park, CO by specialty
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2008; 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.