Active NPI
Intermountain Medical Group Denver, LLC
Doing business as SCL Health Saint Joseph Emergency Department - Aurora
- Primary Care Clinic/Center
- Aurora, CO
National Provider Identifier
1639784010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Clinic/Center
- Legal business name
- INTERMOUNTAIN MEDICAL GROUP DENVER, LLC
- Doing business as
- SCL Health Saint Joseph Emergency Department - Aurora
- Practice address
- 23770 E Smoky Hill Rd
Aurora, CO 80016-3089 - Phone
- (303) 812-2000
- Fax
- (303) 812-4179
- NPI assigned
- Sep 11, 2020
- Last updated
- Jun 28, 2024
- Organization subpart
- Yes
- Parent organization
- INTERMOUNTAIN FRONT RANGE, INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jon McDaniel
- Title
- VP Finance Medical Group
- Phone
- (303) 272-0231
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | Primary |
Addresses
Primary practice location
23770 E Smoky Hill Rd
Aurora, CO 80016-3089
Mailing address
23770 E Smoky Hill Rd
Aurora, CO 80016-3089
Phone (303) 812-2000
Other names 1
- SCL Health Saint Joseph Emergency Department - Aurora
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150106000131 | CO | Part B Supplier - Clinic/Group Practice | 0840513552 |
Receives reassigned benefits from 1,361 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
National Provider Directory- Part of
- Exempla S Bdwy Med CNTR
Locations
23770 E Smoky Hill Rd
Aurora, CO 80016
Phone (303) 812-5045
Practitioners & affiliated clinicians
Practitioners 16
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Hospitalist Physician
- Lafayette, CO
- NPI 1487018495
-
- Neurology Physician
- Denver, CO
- NPI 1316333016
-
- Registered Dietitian
- Centennial, CO
- NPI 1821460213
-
- Physical Therapist
- Denver, CO
- NPI 1245086867
-
- Physical Therapist
- Aurora, CO
- NPI 1649630641
-
- Physical Therapist
- Denver, CO
- NPI 1649842709
-
- Family Medicine Physician
- Golden, CO
- NPI 1558984641
-
- Physical Therapist
- Arvada, CO
- NPI 1841365590
-
- Physical Therapist
- Denver, CO
- NPI 1285986786
-
- Nurse Practitioner
- Lakewood, CO
- NPI 1184863987
-
- Clinical Social Worker
- Lafayette, CO
- NPI 1164263943
-
- Surgery Physician
- San Antonio, TX
- NPI 1760809123
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599782400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1719532800000",
"number": "1639784010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23770 E SMOKY HILL RD",
"city": "AURORA",
"state": "CO",
"postal_code": "800163089",
"telephone_number": "303-812-2000",
"fax_number": "303-812-4179"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23770 E SMOKY HILL RD",
"city": "AURORA",
"state": "CO",
"postal_code": "800163089",
"telephone_number": "303-812-2000",
"fax_number": "303-812-4179"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "INTERMOUNTAIN MEDICAL GROUP DENVER, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "INTERMOUNTAIN FRONT RANGE, INC.",
"enumeration_date": "2020-09-11",
"last_updated": "2024-06-28",
"certification_date": "2024-06-28",
"status": "A",
"authorized_official_last_name": "MCDANIEL",
"authorized_official_first_name": "JON",
"authorized_official_title_or_position": "VP FINANCE MEDICAL GROUP",
"authorized_official_telephone_number": "303-272-0231"
},
"taxonomies": [
{
"code": "261QP2300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Primary Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "SCL Health Saint Joseph Emergency Department - Aurora",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "SCL Health Saint Joseph Emergency Department - Aurora",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Aurora, CO
- Intermountain Medical Group Denver, LLC (Copperleaf Clinic - Primary Care)
- Intermountain Medical Group Denver, LLC (Intermountain Health - Buckley Primary Care)
- Intermountain Medical Group Denver, LLC (Intermountain Health Heart & Vascular - Aurora)
- Intermountain Medical Group Denver, LLC (SCL Health Medical Group - Aurora)
- Intermountain Medical Group Denver, LLC (East Crossroads Clinic - Podiatry)
- Intermountain Medical Group Denver, LLC (East Crossroads Clinic - General Surgery)
- Intermountain Medical Group Denver, LLC (East Crossroads Clinic - Orthopedics)
- Intermountain Medical Group Denver, LLC (East Crossroads Clinic - Primary Care)
- Onechanh Inthamanivong
- Joanna Ioannides, MSW/LCSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.