Individual provider Active NPI

David Wayne Link, M.D. MPH

  • General Practice Physician
  • Boulder, CO
National Provider Identifier
1558389221
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
30981 Issued in CO
Practice address
2750 Broadway St
Boulder, CO 80304-3573
Phone
(303) 440-3200
Fax
(303) 440-3232
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 30981 CO
General Practice Physician 208D00000X 30981 CO Primary

Addresses

Primary practice location

2750 Broadway St
Boulder, CO 80304-3573

Mailing address

2750 Broadway St
Boulder, CO 80304-3586
Phone (303) 440-3200

Other identifiers 3

IdentifierTypeStateIssuer
1558389221MedicaidNE
01309814MedicaidCO
930005409OtherCORAILROAD MEDICARE

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101206000780 CO Practitioner - Emergency MedicinePractitioner - Other (Physician) 2062609852

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30981COMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Colorado Emergency Physicians, PC Current Accepting new patients

Locations

1801 16th St
Greeley, CO 80631
Phone (970) 352-4121

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1558389221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 BROADWAY ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803043586",
            "telephone_number": "303-440-3200",
            "fax_number": "303-440-3232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 BROADWAY ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803043573",
            "telephone_number": "303-440-3200",
            "fax_number": "303-440-3232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINK",
        "first_name": "DAVID",
        "middle_name": "WAYNE",
        "credential": "M.D. MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CO",
            "license": "30981",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CO",
            "license": "30981",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1558389221",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01309814",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "930005409",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.