NPIMap

Organization Active NPI

Platte Valley Medical Group, LLC

Doing business as Platte Valley Medical Group - Brighton Integrative Internal Medicine

  • Internal Medicine Physician
  • Brighton, CO
National Provider Identifier
1508480146
Registry record updated Jun 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PLATTE VALLEY MEDICAL GROUP, LLC
Doing business as
Platte Valley Medical Group - Brighton Integrative Internal Medicine
Practice address
1610 Prairie Center Pkwy Ste 2170
Brighton, CO 80601-4001
Phone
(303) 659-4476
Fax
(303) 659-4508
NPI assigned
May 29, 2020
Last updated
Jun 3, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
BRIGHTON COMMUNITY HOSPITAL ASSOCIATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 3, 2020

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
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1610 Prairie Center Pkwy Ste 2170
Brighton, CO 80601-4001

Mailing address

1610 Prairie Center Pkwy Ste 2170
Brighton, CO 80601-4001
Phone (303) 659-4476

Other names 1

  • Platte Valley Medical Group - Brighton Integrative Internal Medicine 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
Platte Valley Medical Center

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 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1590710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591142400000",
    "number": "1508480146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 PRAIRIE CENTER PKWY STE 2170",
            "city": "BRIGHTON",
            "state": "CO",
            "postal_code": "806014001",
            "telephone_number": "303-659-4476",
            "fax_number": "303-659-4508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 PRAIRIE CENTER PKWY STE 2170",
            "city": "BRIGHTON",
            "state": "CO",
            "postal_code": "806014001",
            "telephone_number": "303-659-4476",
            "fax_number": "303-659-4508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLATTE VALLEY MEDICAL GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BRIGHTON COMMUNITY HOSPITAL ASSOCIATION",
        "enumeration_date": "2020-05-29",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "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": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Platte Valley Medical Group - Brighton Integrative Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Platte Valley Medical Group - Brighton Integrative Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brighton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2020; 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.