NPIMap

Organization Active NPI

Premiere Healthcare Associates LLC

  • Clinic/Center
  • Golden, CO
National Provider Identifier
1700337029
Registry record updated Dec 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
1866 Issued in CO
Legal business name
PREMIERE HEALTHCARE ASSOCIATES LLC
Practice address
14828 W 6TH Ave
Suite 16-B
Golden, CO 80401-5000
Phone
(303) 918-6386
Fax
(303) 232-6201
NPI assigned
Oct 21, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2016

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

Authorized official

Name
Dr. Kathleen Jo Gutierrez, PHD, RN, ANP-BC,ACNS
Title
President/Ceo
Phone
(303) 918-6386

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 1866 CO Primary

Addresses

Primary practice location

14828 W 6TH Ave
Suite 16-B
Golden, CO 80401-5000

Mailing address

15400 W 64TH Ave
Unit 9 Box 359
Arvada, CO 80007-6852
Phone (303) 918-6386

Other identifiers 1

IdentifierTypeStateIssuer
62534084MedicaidCO

National Provider Directory

National Provider Directory

Locations

15400 W 64th Ave
Unit 9
Arvada, CO 80007

NPI Registry JSON

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

{
    "created_epoch": "1477008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482796800000",
    "number": "1700337029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15400 W 64TH AVE",
            "address_2": "UNIT 9 BOX 359",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800076852",
            "telephone_number": "303-918-6386",
            "fax_number": "303-232-6201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14828 W 6TH AVE",
            "address_2": "SUITE 16-B",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804015000",
            "telephone_number": "303-918-6386",
            "fax_number": "303-232-6201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIERE HEALTHCARE ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-21",
        "last_updated": "2016-12-27",
        "status": "A",
        "authorized_official_last_name": "GUTIERREZ",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "303-918-6386",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, RN, ANP-BC,ACNS"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CO",
            "license": "1866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "62534084",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Golden, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2016; 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.