NPIMap

Organization Active NPI

Shalom Park Professional Services LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Aurora, CO
National Provider Identifier
1528232402
Registry record updated Mar 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
1565633 Issued in CO
Legal business name
SHALOM PARK PROFESSIONAL SERVICES LLC
Practice address
14800 E Belleview Drive
Aurora, CO 80015-2258
Phone
(303) 680-5000
Fax
(303) 699-4300
NPI assigned
Apr 22, 2008
Last updated
Mar 18, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
BETH ISRAEL FOUNDATION FOR THE AGEDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 18, 2009

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

Authorized official

Name
Dan Stenersen
Title
Ceo
Phone
(303) 680-5000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 1565633 CO Primary

Addresses

Primary practice location

14800 E Belleview Drive
Aurora, CO 80015-2258

Mailing address

14800 E Belleview Drive
Aurora, CO 80015-2258
Phone (303) 680-5000

National Provider Directory

National Provider Directory

Locations

14800 E Belleview Dr
#D
Aurora, CO 80015
Phone (303) 680-5000

Practitioners & affiliated clinicians

Practitioners 4

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": "1208822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237334400000",
    "number": "1528232402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14800 E BELLEVIEW DRIVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800152258",
            "telephone_number": "303-680-5000",
            "fax_number": "303-699-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14800 E BELLEVIEW DRIVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800152258",
            "telephone_number": "303-680-5000",
            "fax_number": "303-699-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHALOM PARK PROFESSIONAL SERVICES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BETH ISRAEL FOUNDATION FOR THE AGED",
        "enumeration_date": "2008-04-22",
        "last_updated": "2009-03-18",
        "status": "A",
        "authorized_official_last_name": "STENERSEN",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "303-680-5000"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "CO",
            "license": "1565633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2009; 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.