Individual provider Active NPI

Michael Rollin, MD

  • Psychiatry Physician
  • Denver, CO
National Provider Identifier
1609913995
Registry record updated Jan 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
47360 Issued in CO
Practice address
2121 S Oneida St Ste 600
Denver, CO 80224-2555
Phone
(720) 863-6100
NPI assigned
Jan 30, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 47360 CO
Psychiatry Physician 2084P0800X 47360 CO Primary

Addresses

Primary practice location

2121 S Oneida St Ste 600
Denver, CO 80224-2555

Mailing address

3583 Willow St
Denver, CO 80238-3374
Phone (720) 256-3886

Other practice location 1

950 S Cherry St
Suite 1010
Denver, CO 80246-2699
Phone (720) 889-4259

Other identifiers 1

IdentifierTypeStateIssuer
9000143321MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
47360COMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Edc of Denver, LLC Past Accepting new patients
Mind Body Sport, LLC PastSince Jan 10, 2021 Accepting new patients

Organizations & group practices 2

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": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609804800000",
    "number": "1609913995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3583 WILLOW ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802383374",
            "telephone_number": "720-256-3886",
            "fax_number": "720-528-7859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 S ONEIDA ST STE 600",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802242555",
            "telephone_number": "720-863-6100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "950 S Cherry St",
            "address_2": "Suite 1010",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802462699",
            "country_code": "US",
            "telephone_number": "720-889-4259",
            "fax_number": "720-528-7859",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROLLIN",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CO",
            "license": "47360",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "47360",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000143321",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2021; 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.