Active NPI
DTG II PLLC
- Family Medicine Physician
- Boulder, CO
National Provider Identifier
1598445892
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- DTG II PLLC
- Practice address
- 4770 Baseline Rd Ste 200
Boulder, CO 80303-2668 - Phone
- (800) 268-7713
- Fax
- (415) 704-3294
- NPI assigned
- Jul 20, 2023
- Organization subpart
- Yes
- Parent organization
- DTG II PLLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. John M Bernard, MD
- Title
- President
- Phone
- (800) 268-7713
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
4770 Baseline Rd Ste 200
Boulder, CO 80303-2668
Mailing address
811 E Kent Rd
Greenville, MI 48838-9791
Phone (800) 268-7713
Other names 1
- BeyondMD
National Provider Directory
National Provider Directory- Tax ID family
- DTG II PLLC
- Part of
- DTG II PLLC
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689811200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1689811200000",
"number": "1598445892",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "811 E KENT RD",
"city": "GREENVILLE",
"state": "MI",
"postal_code": "488389791",
"telephone_number": "800-268-7713",
"fax_number": "415-704-3294"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4770 BASELINE RD STE 200",
"city": "BOULDER",
"state": "CO",
"postal_code": "803032668",
"telephone_number": "800-268-7713",
"fax_number": "415-704-3294"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DTG II PLLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "DTG II PLLC",
"enumeration_date": "2023-07-20",
"last_updated": "2023-07-20",
"certification_date": "2023-07-20",
"status": "A",
"authorized_official_last_name": "BERNARD",
"authorized_official_first_name": "JOHN",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "800-268-7713",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "BeyondMD",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.