Southpark Internal Medicine PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

29558 Issued in CO

Legal business name

SOUTHPARK INTERNAL MEDICINE PC

Practice address

9088 Ridgeline Blvd
Ste 201
Highlands Ranch, CO 80129-2383

Phone

(720) 266-6900

Fax

(303) 791-9920

NPI assigned

Mar 16, 2007

Last updated

Aug 9, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ellen M BurkettNPI 1659334118

Title

MD

Phone

(720) 266-6900

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• Ellen Marie Burkett, MD

  • Internal Medicine Physician
  • Highlands Ranch, CO
  • NPI 1659334118
  Authorized official Same address or phone
• Lora A Jackson, NP

  • Adult Health Nurse Practitioner
  • Highlands Ranch, CO
  • NPI 1083760938
  NPD (past)

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376006400000",
    "number": "1538293790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9088 RIDGELINE BLVD",
            "address_2": "STE 201",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "801292383",
            "telephone_number": "720-266-6900",
            "fax_number": "303-791-9920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9088 RIDGELINE BLVD",
            "address_2": "STE 201",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "801292383",
            "telephone_number": "720-266-6900",
            "fax_number": "303-791-9920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHPARK INTERNAL MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2013-08-09",
        "status": "A",
        "authorized_official_last_name": "BURKETT",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "720-266-6900"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "29558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krupa M Soni, DDS
• Heather Dawn Sonner, CSFA
• Jessica Sorensen, PA
• Sorianna Homecare Company
• South Metro Integrated Clinic
• Speak Up Unlimited LLC
• Donna Specht
• Sydnee Spector, DMD
• Speech and Song for Extraordinary Kids, LLC
• Speech Within Reach, LLC

• Internal Medicine Physician in Highlands Ranch, CO
• Providers in Highlands Ranch, CO by specialty
• Internal Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2013; 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.