Active NPI
Luc Allan Overholt, M.D.
- Internal Medicine Physician
- Golden, CO
National Provider Identifier
1518596824
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- DR.0069579
- Practice address
- 1020 Johnson Road
Golden, CO 80401-6002 - Phone
- (303) 914-2680
- Fax
- (720) 723-7928
- NPI assigned
- Apr 7, 2020
- Last updated
- Sep 28, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | DR.0069579 | CO | Primary |
Addresses
Primary practice location
1020 Johnson Road
Golden, CO 80401-6002
Mailing address
1020 Johnson Road
Golden, CO 80401-6002
Phone (720) 723-5027
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200629001157 | CO | Order and Referring Only - Internal Medicine | 5799107371 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DR.0069579 | CO | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695859200000",
"number": "1518596824",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1020 JOHNSON ROAD",
"city": "GOLDEN",
"state": "CO",
"postal_code": "804016002",
"telephone_number": "720-723-5027",
"fax_number": "720-723-7928"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1020 JOHNSON ROAD",
"city": "GOLDEN",
"state": "CO",
"postal_code": "804016002",
"telephone_number": "303-914-2680",
"fax_number": "720-723-7928"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OVERHOLT",
"first_name": "LUC",
"middle_name": "ALLAN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-04-07",
"last_updated": "2023-09-28",
"certification_date": "2023-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CO",
"license": "DR.0069579",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Golden, CO
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- Sharon K Oxford-Duffy, OCCUPATIONAL THERAPI
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- David Paul Palik
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.