Tjdmedical Center

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

39589 Issued in CO

Legal business name

TJDMEDICAL CENTER

Practice address

4251 Kipling St
Suite 560
Wheat Ridge, CO 80033-2896

Phone

(720) 898-8900

Fax

(720) 898-8901

NPI assigned

Jan 3, 2008

Organization subpart

No

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

Authorized official

Name

Terry Gardner, DO

Title

Owner

Phone

(720) 898-8900

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1199318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199318400000",
    "number": "1497930945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4251 KIPLING ST",
            "address_2": "SUITE 560",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800332896",
            "telephone_number": "720-898-8900",
            "fax_number": "720-898-8901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4251 KIPLING ST",
            "address_2": "SUITE 560",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800332896",
            "telephone_number": "720-898-8900",
            "fax_number": "720-898-8901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TJDMEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-03",
        "last_updated": "2008-01-03",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "720-898-8900",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CO",
            "license": "39589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "83685731",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Baillie Tichy
• Tiffany Manzo Jenkins
• Patrick Thomas Tiffany, MD
• Matthew Tilton
• Philippe A. Tirman, M.D.
• Brady Harper Tkachyk, RN
• Anna Lenore To
• Taylor Tobin
• Allison Todd, R.N.
• Madlena Todorova

• Clinic/Center in Wheat Ridge, CO
• Providers in Wheat Ridge, CO by specialty
• Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.