Providence Healthcare Associates PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PROVIDENCE HEALTHCARE ASSOCIATES PC

Practice address

2761 W 120TH Ave
Suite 100
Westminster, CO 80234-2880

Phone

(303) 357-5620

NPI assigned

Jul 3, 2007

Organization subpart

No

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

Authorized official

Name

Michael Corey McCarty, D.O.NPI 1073578894

Title

Physician-Owner

Phone

(720) 985-6484

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Corey McCarty, D.O.

  • Family Medicine Physician
  • Boulder, CO
  • NPI 1073578894
  NPD (past) Authorized official

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184025600000",
    "number": "1740488535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2761 W 120TH AVE",
            "address_2": "SUITE 100",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "802342880",
            "telephone_number": "303-357-5620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2761 W 120TH AVE",
            "address_2": "SUITE 100",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "802342880",
            "telephone_number": "303-357-5620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HEALTHCARE ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-03",
        "last_updated": "2007-07-10",
        "status": "A",
        "authorized_official_last_name": "MCCARTY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "COREY",
        "authorized_official_title_or_position": "PHYSICIAN-OWNER",
        "authorized_official_telephone_number": "720-985-6484",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Westminster, CO
• Providers in Westminster, CO by specialty
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; 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.