Intermountain Medical Group Denver, LLC
Organization Active NPI Foot & Ankle Surgery Podiatrist · Thornton, CO
NPI 1730533902 · NPPES record last updated Jun 28, 2024
Key facts
- NPI
- 1730533902
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Foot & Ankle Surgery Podiatrist 213ES0103X
- License
- POD.0000520 (CO)
- Legal business name
- INTERMOUNTAIN MEDICAL GROUP DENVER, LLC
- Practice address
- 9351 Grant St
Ste 490
Thornton, CO 80229-4358 - Phone
- (303) 451-5271
- Fax
- (303) 452-4398
- NPI assigned
- Apr 14, 2016
- Organization subpart
- Yes
- Parent organization (as reported)
- INTERMOUNTAIN FRONT RANGE, INC.
Authorized official
- Name
- Jon McDaniel
- Title
- VP Finance - MGPS Operations
- Phone
- (303) 272-0231
Other NPIs with the same Medicare PAC ID 3
Member of 3
Practitioners 571
-
Victor James Abela, D.O.
-
Lisa Ahrendt, MD
-
Nicole Alford, DPT
-
Brian Joseph Allen, M.D.
-
Jose Amador, FNP-BC
-
Ankie Marie Amos, MD
-
Emily Anderson, PA
-
Kate Anderson, DPT
-
John J Archard, M.D.
-
Alex N Ashton, PAC
-
Darryl Allen Auston, MD PHD
-
Ellyn Ann Ayervais, PA-C
-
Ari P Ballonoff, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160414001983 | CO | DME Supplier - Physician - Podiatry | 0840513552 | Practice locations: Northglenn, CO |
National Provider Directory
- Part of
- Sisters of Charity of Leavenworth Health System Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist |
213ES0103X | POD.0000520 | CO | Yes |
Addresses
Primary practice location
9351 Grant St
Ste 490
Thornton, CO 80229-4358
Mailing address
9351 Grant St
Ste 490
Thornton, CO 80229-4358
Phone (303) 451-5271
Other names
- Community Foot & Ankle Clinic - DME
- SCLP Community Foot & Ankle Clinic
Other providers in Thornton, CO
- Insite Therapy Services LLC
- Integral Physical Therapy LLC
- Integrity Chiropractic LLC
- Intermountain Community Support and Services, LLC
- Intermountain Medical Group Denver, LLC
- Intermountain Medical Group Denver, LLC
- Intrepid Bodyworks, LLC
- Charlotte Iobe
- William Ernesto Irizarry Jr.
- Christopher L Isaacs
All providers in Thornton, CO · Foot & Ankle Surgery Podiatrist in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 28, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.