Organization Active NPI

Willcoll, LLC

  • Clinical Neurophysiology Physician
  • Lone Tree, CO
National Provider Identifier
1558789495
Registry record updated Oct 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X
License
20141104585 Issued in CO
Legal business name
WILLCOLL, LLC
Practice address
9695 S Yosemite St
#377
Lone Tree, CO 80124-2888
Phone
(303) 814-1340
Fax
(303) 814-1134
NPI assigned
Mar 28, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2014

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

Authorized official

Name
Dr. Lloyd Wesley Mobley III, M.D.
Title
Owner
Phone
(720) 985-5899

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neurophysiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0600X 20141104585 CO Primary

Addresses

Primary practice location

9695 S Yosemite St
#377
Lone Tree, CO 80124-2888

Mailing address

9695 S Yosemite St
#377
Lone Tree, CO 80124-2888
Phone (303) 814-1340

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1395964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412294400000",
    "number": "1558789495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9695 S YOSEMITE ST",
            "address_2": "#377",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801242888",
            "telephone_number": "303-814-1340",
            "fax_number": "303-814-1134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9695 S YOSEMITE ST",
            "address_2": "#377",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801242888",
            "telephone_number": "303-814-1340",
            "fax_number": "303-814-1134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLCOLL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-28",
        "last_updated": "2014-10-03",
        "status": "A",
        "authorized_official_last_name": "MOBLEY",
        "authorized_official_first_name": "LLOYD",
        "authorized_official_middle_name": "WESLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "720-985-5899",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "CO",
            "license": "20141104585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lone Tree, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2014; 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.