NPIMap

Organization Active NPI

Northwest Family Medicine

  • Primary Care Clinic/Center
  • Superior, CO
National Provider Identifier
1720084635
Registry record updated Jan 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
105493 Issued in CO
Legal business name
NORTHWEST FAMILY MEDICINE
Practice address
500 Discovery Pkwy
Ste 150
Superior, CO 80027-8639
Phone
(303) 425-9581
NPI assigned
Jun 24, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2008

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

Authorized official

Name
Devin Detwiler
Title
Practice Administrator
Phone
(303) 425-9581

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 105493 CO Primary

Addresses

Primary practice location

500 Discovery Pkwy
Ste 150
Superior, CO 80027-8639

Mailing address

500 Discovery Pkwy
Suite 150
Superior, CO 80027-8639
Phone (303) 425-9581

National Provider Directory

National Provider Directory

Locations

500 Discovery Pkwy
Ste 150
Superior, CO 80027
Phone (303) 425-9581

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199664000000",
    "number": "1720084635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 DISCOVERY PKWY",
            "address_2": "SUITE 150",
            "city": "SUPERIOR",
            "state": "CO",
            "postal_code": "800278639",
            "telephone_number": "303-425-9581",
            "fax_number": "303-425-9259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 DISCOVERY PKWY",
            "address_2": "STE 150",
            "city": "SUPERIOR",
            "state": "CO",
            "postal_code": "800278639",
            "telephone_number": "303-425-9581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-24",
        "last_updated": "2008-01-07",
        "status": "A",
        "authorized_official_last_name": "DETWILER",
        "authorized_official_first_name": "DEVIN",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "303-425-9581"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CO",
            "license": "105493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Superior, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.