Organization Active NPI

SCL Health Front Range Inc

  • Surgery Physician
  • Wheat Ridge, CO
National Provider Identifier
1730706607
Registry record updated Dec 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
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 INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 22, 2020

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)CodeLicenseStatePrimary
Obesity Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RB0002X
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 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 Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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.

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.

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.

Verify at the official NPI Registry.