NPIMap

Individual provider Active NPI

John R Willard, D.O.

  • Family Medicine Physician
  • Centennial, CO
National Provider Identifier
1528124369
Registry record updated Oct 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
30373 Issued in CO
Practice address
14100 E Arapahoe Rd
Suite 170
Centennial, CO 80112-4028
Phone
(303) 699-3190
Fax
(303) 699-3189
NPI assigned
Dec 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X 30373 CO
Family Medicine Physician 207Q00000X 30373 CO Primary

Addresses

Primary practice location

14100 E Arapahoe Rd
Suite 170
Centennial, CO 80112-4028

Mailing address

14100 E Arapahoe Rd
Suite 170
Centennial, CO 80112-4028
Phone (303) 699-3190

Other identifiers 1

IdentifierTypeStateIssuer
01303734MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050913000016 CO Practitioner - Family Practice 6608809538 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
College of Osteo Med of the Pacific at Pomona, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr. Willard'S Family Practice, P.C.Group PAC ID 2365765765, 3 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

14100 E Arapahoe Rd
Centennial, CO 80112-4048

22 S Adams St
Denver, CO 80209-2908
Phone (303) 321-2452

Hospital & facility affiliations

  • Bayada Home Health Care Inc Home health agency, Denver, CO, CCN 067056
  • Optimal Home Care Inc Home health agency, Denver, CO, CCN 067453
  • Berkley Home Health Home health agency, Aurora, CO, CCN 067407
  • The Medical Center of Aurora & South Hospital Hospital, Aurora, CO, CCN 060100
  • AdventHealth Parker Hospital, Parker, CO, CCN 060114
  • Sky Ridge Medical Center Hospital, Lone Tree, CO, CCN 060112
  • University of Colorado Hospital Authority Hospital, Aurora, CO, CCN 060024

Merit-based Incentive Payment System (MIPS)

Final score
90 of 100Reported as group
Quality
100
Improvement activities
40
Cost
66.67

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
30373COMDNeuromusculoskeletal Medicine & OMM Physician

Organizations & group practices 2

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.

Hospital & facility affiliations 52

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 52

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1528124369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14100 E ARAPAHOE RD",
            "address_2": "SUITE 170",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801124028",
            "telephone_number": "303-699-3190",
            "fax_number": "303-699-3189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14100 E ARAPAHOE RD",
            "address_2": "SUITE 170",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801124028",
            "telephone_number": "303-699-3190",
            "fax_number": "303-699-3189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLARD",
        "first_name": "JOHN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "CO",
            "license": "30373",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "30373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01303734",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Centennial, CO

Sources for this page

Verify at the official NPI Registry.