Organization Active NPI

Living Well Family Medicine PC

Doing business as Paragon Family Medicine, PC

  • Family Medicine Physician
  • Denver, CO
National Provider Identifier
1730534637
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
41315 Issued in CO
Legal business name
LIVING WELL FAMILY MEDICINE PC
Doing business as
Paragon Family Medicine, PC
Practice address
4999 E Kentucky Ave Ste 103
Denver, CO 80246-3901
Phone
(720) 770-8199
Fax
(720) 770-8399
NPI assigned
Apr 28, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

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

Authorized official

Name
Dr. Mary Catherine Husney, MDNPI 1588607816
Title
President
Phone
(303) 204-6374

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 41315 CO Primary

Addresses

Primary practice location

4999 E Kentucky Ave Ste 103
Denver, CO 80246-3901

Mailing address

4999 E Kentucky Ave Ste 103
Denver, CO 80246-3901
Phone (720) 770-8199

Other identifiers 1

IdentifierTypeStateIssuer
93179065MedicaidCO

Other names 1

  • Paragon Family Medicine, PC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161011002893 CO Part B Supplier - Clinic/Group Practice 0244528065 Receives reassigned benefits from 1 practitioner
Practice locations: Denver, CO

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D2116206Living Well Family Medicine PC4999 E Kentucky Ave 103, Denver, CO 80246Provider-performed microscopyJul 20, 2028

National Provider Directory

National Provider Directory

Locations

695 S Colorado Blvd
Ste 160
Denver, CO 80246
Phone (303) 991-7979

4999 E Kentucky Ave
Ste 103
Denver, CO 80246
Phone (720) 770-8199

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": "1461801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630454400000",
    "number": "1730534637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4999 E KENTUCKY AVE STE 103",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802463901",
            "telephone_number": "720-770-8199",
            "fax_number": "720-770-8399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4999 E KENTUCKY AVE STE 103",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802463901",
            "telephone_number": "720-770-8199",
            "fax_number": "720-770-8399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING WELL FAMILY MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-28",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A",
        "authorized_official_last_name": "HUSNEY",
        "authorized_official_first_name": "MARY CATHERINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "303-204-6374",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "41315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "93179065",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Paragon Family Medicine, PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.