Active NPI
Lifetime Healthcare & Medical
- Sports Physician Chiropractor
- Broomfield, CO
National Provider Identifier
1750023297
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physician Chiropractor
- Legal business name
- LIFETIME HEALTHCARE & MEDICAL
- Practice address
- 8155 W 94TH Ave
Broomfield, CO 80021-4515 - Phone
- (303) 423-4610
- Fax
- (303) 431-8658
- NPI assigned
- Apr 13, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Randy Bruce Snyder, D.C.
- Title
- President
- Phone
- (303) 423-4610
Specialties & licenses 12
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | |||
| Sports Physician Chiropractor | 111NS0005X | Primary | ||
| Licensed Practical Nurse | 164W00000X | |||
| Acupuncturist | 171100000X | |||
| Neuromusculoskeletal Medicine & OMM Physician | 204D00000X | |||
| Physical Medicine & Rehabilitation Physician | 208100000X | |||
| Sports Medicine (Preventive Medicine) Physician | 2083S0010X | |||
| Sports Physical Therapist | 2251S0007X | |||
| Physical Therapy Assistant | 225200000X | |||
| Medical Physician Assistant | 363AM0700X | |||
| Nurse Practitioner | 363L00000X | |||
| Primary Care Nurse Practitioner | 363LP2300X |
Addresses
Primary practice location
8155 W 94TH Ave
Broomfield, CO 80021-4515
Mailing address
8155 W 94TH Ave
Broomfield, CO 80021-4515
Phone (303) 423-4610
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649808000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1652313600000",
"number": "1750023297",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8155 W 94TH AVE",
"city": "BROOMFIELD",
"state": "CO",
"postal_code": "800214515",
"telephone_number": "303-423-4610",
"fax_number": "303-431-8658"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8155 W 94TH AVE",
"city": "BROOMFIELD",
"state": "CO",
"postal_code": "800214515",
"telephone_number": "303-423-4610",
"fax_number": "303-431-8658"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LIFETIME HEALTHCARE & MEDICAL",
"organizational_subpart": "NO",
"enumeration_date": "2022-04-13",
"last_updated": "2022-05-12",
"certification_date": "2022-05-06",
"status": "A",
"authorized_official_last_name": "SNYDER",
"authorized_official_first_name": "RANDY",
"authorized_official_middle_name": "BRUCE",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "303-423-4610",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.C."
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Chiropractor",
"state": null,
"license": null,
"primary": false
},
{
"code": "111NS0005X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Chiropractor, Sports Physician",
"state": null,
"license": null,
"primary": true
},
{
"code": "164W00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Licensed Practical Nurse",
"state": null,
"license": null,
"primary": false
},
{
"code": "171100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Acupuncturist",
"state": null,
"license": null,
"primary": false
},
{
"code": "204D00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Neuromusculoskeletal Medicine & OMM",
"state": null,
"license": null,
"primary": false
},
{
"code": "208100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Medicine & Rehabilitation",
"state": null,
"license": null,
"primary": false
},
{
"code": "2083S0010X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Preventive Medicine, Sports Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "2251S0007X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist, Sports",
"state": null,
"license": null,
"primary": false
},
{
"code": "225200000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapy Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physician Assistant, Medical",
"state": null,
"license": null,
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LP2300X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Primary Care",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Broomfield, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.