Active NPI
Paul Randolph Flippen, P.A.
- Medical Physician Assistant
- Broomfield, CO
National Provider Identifier
1710905534
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 00070
- Practice address
- 1420 W Midway Blvd
Broomfield, CO 80020-2090 - Phone
- (303) 466-1866
- Fax
- (303) 466-4081
- NPI assigned
- Jul 18, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 00070 | CO | Primary |
Addresses
Primary practice location
1420 W Midway Blvd
Broomfield, CO 80020-2090
Mailing address
98 N Cedar Brook Rd
Boulder, CO 80304-0415
Phone (303) 443-1020
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 70 | CO | MD | Dentist |
| 00070 | CO | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1710905534",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "98 N CEDAR BROOK RD",
"city": "BOULDER",
"state": "CO",
"postal_code": "803040415",
"telephone_number": "303-443-1020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1420 W MIDWAY BLVD",
"city": "BROOMFIELD",
"state": "CO",
"postal_code": "800202090",
"telephone_number": "303-466-1866",
"fax_number": "303-466-4081"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLIPPEN",
"first_name": "PAUL",
"middle_name": "RANDOLPH",
"name_prefix": "Mr.",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CO",
"license": "00070",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Broomfield, CO
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- Edward M Fleegler, MD
- Brooke Lundy Fleischmann, DDS
- David Henry Fleischmann, DDS
- Sarah Anne Fletcher, MS, LPC
- Chelsea Anne Fogg
- Forefront Dermatology SC
- Form and Fitness Physical Therapy
- Form and Fitness Physical Therapy LLC
- Jessica Leigh Forman
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.