Active NPI
SCL Health Front Range Inc
- Surgery Physician
- Wheat Ridge, CO
National Provider Identifier
1730706607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- Legal business name
- SCL HEALTH FRONT RANGE INC
- Practice address
- 3455 Lutheran Pkwy Ste 220
Wheat Ridge, CO 80033-6029 - Phone
- (303) 403-3030
- Fax
- (303) 403-6907
- NPI assigned
- Jun 26, 2020
- Organization subpart
- Yes
- Parent organization
- SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sean Fadden
- Title
- VP Finance
- Phone
- (303) 425-2410
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obesity Medicine (Internal Medicine) Physician | 207RB0002X | |||
| Surgery Physician | 208600000X | Primary |
Addresses
Primary practice location
3455 Lutheran Pkwy Ste 220
Wheat Ridge, CO 80033-6029
Mailing address
500 Eldorado Blvd Ste 6300
Broomfield, CO 80021-3422
Phone (303) 272-0566
Other names 1
- Lutheran Weight Loss Clinic
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040130000049 | CO | Part B Supplier - Clinic/Group Practice | 6800799537 |
Receives reassigned benefits from 119 practitioners 8 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Golden, CO; Wheat Ridge, CO |
Other NPIs on the same Medicare enrollment 8
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Internal Medicine Physician
- Wheat Ridge, CO
- NPI 1083444079
O20040130000049
-
- Radiation Oncology Physician
- Golden, CO
- NPI 1437737665
O20040130000049
-
- Obesity Medicine (Internal Medicine) Physician
- Lafayette, CO
- NPI 1609493576
O20040130000049
-
- Psychiatric Hospital Unit
- Wheat Ridge, CO
- NPI 1629053731
O20040130000049
-
- Hospice and Palliative Medicine (Internal Medicine) Physician
- Wheat Ridge, CO
- NPI 1649210188
O20040130000049
-
- General Acute Care Hospital
- Wheat Ridge, CO
- NPI 1669461281
O20040130000049
-
- Radiation Oncology Physician
- Wheat Ridge, CO
- NPI 1851975304
O20040130000049
National Provider Directory
National Provider Directory- Part of
- Sisters of Charity of Leavenworth Health System Inc
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
- Institutional Pharmacy
- Wheat Ridge, CO
- NPI 1629515028
Member Of
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1593129600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1608595200000",
"number": "1730706607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 ELDORADO BLVD STE 6300",
"city": "BROOMFIELD",
"state": "CO",
"postal_code": "800213422",
"telephone_number": "303-272-0566",
"fax_number": "303-272-0390"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3455 LUTHERAN PKWY STE 220",
"city": "WHEAT RIDGE",
"state": "CO",
"postal_code": "800336029",
"telephone_number": "303-403-3030",
"fax_number": "303-403-6907"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SCL HEALTH FRONT RANGE INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC",
"enumeration_date": "2020-06-26",
"last_updated": "2020-12-22",
"certification_date": "2020-12-22",
"status": "A",
"authorized_official_last_name": "FADDEN",
"authorized_official_first_name": "SEAN",
"authorized_official_title_or_position": "VP FINANCE",
"authorized_official_telephone_number": "303-425-2410"
},
"taxonomies": [
{
"code": "207RB0002X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Obesity Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Surgery",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Lutheran Weight Loss Clinic",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Lutheran Weight Loss Clinic",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Wheat Ridge, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.