Individual provider Active NPI

Sam Anouna, M.D.

  • Gastroenterology Physician
  • Thornton, CO
National Provider Identifier
1639119365
Registry record updated Jun 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
21935 Issued in CO
Practice address
10001 N Washington St
Thornton, CO 80229-2050
Phone
(303) 252-4442
Fax
(303) 429-6714
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 21935 CO Primary

Addresses

Primary practice location

10001 N Washington St
Thornton, CO 80229-2050

Mailing address

10403 W Colfax Ave Ste 630
Lakewood, CO 80215-3812
Phone (303) 205-1090

Other identifiers 2

IdentifierTypeStateIssuer
01219351MedicaidCO
100008788OtherCORAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100804000775 CO Practitioner - Gastroenterology 4082609722 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21935COMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rocky Mountain Gastroenterology Associates, PLLC Gastroenterology CurrentSince Jul 17, 1996 Accepting new patients

Locations

3333 S Wadsworth Blvd
Unit D100
Lakewood, CO 80227

355 Union Blvd
Ste 10
Lakewood, CO 80228
Phone (303) 689-8700

10001 Washington St
Thornton, CO 80229
Phone (303) 252-0083

Interoperability endpoints

  • Direct secure messaging: samanouna@rmgpllc.allscriptsdirect.net

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276646400000",
    "number": "1639119365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10403 W COLFAX AVE STE 630",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802153812",
            "telephone_number": "303-205-1090",
            "fax_number": "303-205-1120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10001 N WASHINGTON ST",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802292050",
            "telephone_number": "303-252-4442",
            "fax_number": "303-429-6714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANOUNA",
        "first_name": "SAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2010-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CO",
            "license": "21935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01219351",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "100008788",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thornton, CO

Sources for this page

Verify at the official NPI Registry.