Individual provider Active NPI

Michael Thomas Coombs, ATC

  • Pediatric Sports Medicine Physician
  • Aurora, CO
National Provider Identifier
1669057402
Registry record updated Mar 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Sports Medicine PhysicianTaxonomy code 2080S0010X
License
AT.0001671 Issued in CO
Practice address
13123 E 16TH Ave
Aurora, CO 80045-7106
Phone
(708) 351-1301
NPI assigned
Mar 12, 2021
Last updated
Mar 12, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Sports Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080S0010X AT.0001671 CO Primary

Addresses

Primary practice location

13123 E 16TH Ave
Aurora, CO 80045-7106

Mailing address

640 Magnolia St
Denver, CO 80220-6036
Phone (708) 351-1301

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL Direct Other

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

State licenses

LicenseStateTypeSpecialty
AT.0001671COMDPediatric Sports Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1615507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615507200000",
    "number": "1669057402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 MAGNOLIA ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802206036",
            "telephone_number": "708-351-1301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13123 E 16TH AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800457106",
            "telephone_number": "708-351-1301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOMBS",
        "first_name": "MICHAEL",
        "middle_name": "THOMAS",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-12",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080S0010X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Sports Medicine",
            "state": "CO",
            "license": "AT.0001671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Direct",
            "affiliation": "N",
            "endpointDescription": "SOAP URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Denver",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "13123 E 16th Ave",
            "city": "Aurora",
            "state": "CO",
            "country_code": "US",
            "postal_code": "800457106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.