Metro Community Provider Network Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

License

18J548 Issued in CO

Legal business name

METRO COMMUNITY PROVIDER NETWORK INC

Practice address

460 County Road 43
Suite 2
Bailey, CO 80421-2503

Phone

(303) 838-1166

Fax

(303) 838-1124

NPI assigned

Jul 18, 2008

Last updated

Dec 10, 2008By the provider in NPPES

Organization subpart

Yes

Parent organization

METRO COMMUNITY PROVIDER NETWORK INCAs reported in NPPES

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

Authorized official

Name

David Myers

Title

Ceo

Phone

(303) 761-1977

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Platte Canyon Clinic Other name

Part of

Metro Community Provider Networkinc

Locations

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

{
    "created_epoch": "1216339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228867200000",
    "number": "1609031665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 S BROADWAY",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801133611",
            "telephone_number": "303-761-1977",
            "fax_number": "303-761-2787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 COUNTY ROAD 43",
            "address_2": "SUITE 2",
            "city": "BAILEY",
            "state": "CO",
            "postal_code": "804212503",
            "telephone_number": "303-838-1166",
            "fax_number": "303-838-1124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METRO COMMUNITY PROVIDER NETWORK INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "METRO COMMUNITY PROVIDER NETWORK INC",
        "enumeration_date": "2008-07-18",
        "last_updated": "2008-12-10",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "303-761-1977"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CO",
            "license": "18J548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11033894",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Platte Canyon Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Jennifer Lynn Marschel, CMT
• Judith Mayne
• Metro Music Therapy, Inc.
• Michele Mortensen, LLC
• Charity A Morris, MA
• Michele L Mortensen, LPC
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• Federally Qualified Health Center (FQHC) in Bailey, CO
• Providers in Bailey, CO by specialty
• Federally Qualified Health Center (FQHC) in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2008; 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.