Individual provider Active NPI

John E Gottlieb, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Frisco, CO
National Provider Identifier
1710983697
Registry record updated Feb 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
22447 Issued in CO
Practice address
360 Peak One Drive
Ste 180
Frisco, CO 80443
Phone
(970) 668-3633
Fax
(970) 668-4406
NPI assigned
Jun 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 22447 CO Primary

Addresses

Primary practice location

360 Peak One Drive
Ste 180
Frisco, CO 80443

Mailing address

PO Box 1921
Englewood, CO 80150-1921
Phone (970) 241-0202

Other identifiers 1

IdentifierTypeStateIssuer
01224476MedicaidCO

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
22447COMDSports Medicine (Orthopaedic Surgery) Physician

NPI Registry JSON

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202947200000",
    "number": "1710983697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1921",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801501921",
            "telephone_number": "970-241-0202",
            "fax_number": "970-245-0250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 PEAK ONE DRIVE",
            "address_2": "STE 180",
            "city": "FRISCO",
            "state": "CO",
            "postal_code": "80443",
            "telephone_number": "970-668-3633",
            "fax_number": "970-668-4406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTLIEB",
        "first_name": "JOHN",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-24",
        "last_updated": "2008-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "CO",
            "license": "22447",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01224476",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2008; 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.