NPIMap

Organization Active NPI

South Denver Nephrology Associates PLLC

  • Nephrology Physician
  • Denver, CO
National Provider Identifier
1710910823
Registry record updated Dec 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
23200 Issued in CO
Legal business name
SOUTH DENVER NEPHROLOGY ASSOCIATES PLLC
Practice address
950 E Harvard Ave
Suite 240
Denver, CO 80210-7006
Phone
(303) 871-0977
Fax
(303) 733-2387
NPI assigned
Jul 9, 2006
Last updated
Dec 11, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2013

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

Authorized official

Name
Mark A Dillingham, M.DNPI 1437142734
Title
President/Partner
Phone
(303) 891-0977

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X NU
Nephrology Physician 207RN0300X 23200 CO Primary

Addresses

Primary practice location

950 E Harvard Ave
Suite 240
Denver, CO 80210-7006

Mailing address

950 E Harvard Ave
Suite 240
Denver, CO 80210-7006
Phone (303) 871-0977

Other identifiers 1

IdentifierTypeStateIssuer
04015087MedicaidCO

National Provider Directory

National Provider Directory

Locations

950 E Harvard Ave
Ste 240
Denver, CO 80210
Phone (303) 871-0977

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386720000000",
    "number": "1710910823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 E HARVARD AVE",
            "address_2": "SUITE 240",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802107006",
            "telephone_number": "303-871-0977",
            "fax_number": "303-733-2387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 E HARVARD AVE",
            "address_2": "SUITE 240",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802107006",
            "telephone_number": "303-871-0977",
            "fax_number": "303-733-2387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH DENVER NEPHROLOGY ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2013-12-11",
        "status": "A",
        "authorized_official_last_name": "DILLINGHAM",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT/PARTNER",
        "authorized_official_telephone_number": "303-891-0977",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CO",
            "license": "23200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04015087",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2013; 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.