Individual provider Active NPI

Patrick J Demuth, MD

  • Internal Medicine Physician
  • Colorado Springs, CO
National Provider Identifier
1730155508
Registry record updated Oct 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
23197 Issued in CO
Practice address
2405 Research Parkway
Colorado Springs, CO 80920-3420
Phone
(719) 522-1133
Fax
(719) 264-1772
NPI assigned
Feb 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 23197 CO Primary

Addresses

Primary practice location

2405 Research Parkway
Colorado Springs, CO 80920-3420

Mailing address

2405 Research Parkway
Colorado Springs, CO 80920-3420
Phone (719) 522-1133

Other identifiers 1

IdentifierTypeStateIssuer
01230978MedicaidCO

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
23197COMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317945600000",
    "number": "1730155508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2405 RESEARCH PARKWAY",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809203420",
            "telephone_number": "719-522-1133",
            "fax_number": "719-264-1772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 RESEARCH PARKWAY",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809203420",
            "telephone_number": "719-522-1133",
            "fax_number": "719-264-1772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMUTH",
        "first_name": "PATRICK",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2011-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "23197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01230978",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2011; 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.