Colorado Provider Network LLC

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

Legal business name

COLORADO PROVIDER NETWORK LLC

Practice address

1435 Garrison St Ste 110
Lakewood, CO 80215-4748

Phone

(720) 241-3765

NPI assigned

Apr 16, 2021

Last updated

Jun 23, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John Marquez, PA-CNPI 1023153723

Title

Ceo

Phone

(720) 320-3218

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Locations

Practitioners 5

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.

• John Edward Marquez, PAC

  • Medical Physician Assistant
  • Englewood, CO
  • NPI 1023153723
  Medicare reassignment Care Compare group Authorized official
• Megan D Edwards, FNP-C

  • Family Nurse Practitioner
  • Lakewood, CO
  • NPI 1427674654
  Medicare reassignment Care Compare group NPD
• Jennifer L Seibert, M.D.

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Aurora, CO
  • NPI 1770647216
  Medicare reassignment Care Compare group NPD
• Evan Alexandra Glover, PA-C

  • Physician Assistant
  • Lakewood, CO
  • NPI 1366912230
  Medicare reassignment Care Compare group
• Paul Joseph Hongo

  • Medical Physician Assistant
  • Denver, CO
  • NPI 1598004954
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1618531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687478400000",
    "number": "1649851155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12375",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802120375",
            "telephone_number": "303-668-5231",
            "fax_number": "720-358-5897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1435 GARRISON ST STE 110",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802154748",
            "telephone_number": "720-241-3765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO PROVIDER NETWORK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-16",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A",
        "authorized_official_last_name": "MARQUEZ",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "720-320-3218",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colorado PGX Consulting LLC
• Colorado Physical Therapy Network
• Colorado Physician Partners, PLLC
• Colorado Professional Medical, Inc
• Colorado Provider Network LLC (Achieve Health)
• Colorado Relationship Practice
• Colorado Retina Associates, PLLC
• Colorado Retina Associates, PLLC
• Colorado Trauma Services PC
• Colorado Urologic Surgery Center LLC

• Adult Medicine Physician in Lakewood, CO
• Providers in Lakewood, CO by specialty
• Adult Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2023; 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.

Verify at the official NPI Registry.