NPIMap

Organization Active NPI

Mile High Psychiatry LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Aurora, CO
National Provider Identifier
1760928766
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
MILE HIGH PSYCHIATRY LLC
Practice address
14221 E 4TH Ave Ste 2-126
Aurora, CO 80011-8717
Phone
(720) 507-4779
Fax
(720) 367-5067
NPI assigned
Jan 13, 2017
Last updated
Sep 3, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2024

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

Authorized official

Name
Michael K ChismNPI 1154780757
Title
Owner
Phone
(720) 507-4779

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU
Acute Care Nurse Practitioner 363LA2100X NU
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU Primary
Mental Health Counselor 101YM0800X NU

Addresses

Primary practice location

14221 E 4TH Ave Ste 2-126
Aurora, CO 80011-8717

Mailing address

15355 E Colfax Ave Unit 111717
Aurora, CO 80042-1975

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190319000566 CO Part B Supplier - Clinic/Group Practice 9032459656 Receives reassigned benefits from 41 practitioners
2 other NPIs on this enrollment
Practice locations: Aurora, CO; Northglenn, CO

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

14221 E 4th Ave
Ste 2126
Aurora, CO 80011
Phone (720) 262-7502

14221 E 4th Ave
Ste 2330
Aurora, CO 80011

2675 S Abilene St
Ste 100
Aurora, CO 80014

Practitioners & affiliated clinicians

Practitioners 49

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 49

NPI Registry JSON

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

{
    "created_epoch": "1484265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725321600000",
    "number": "1760928766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15355 E COLFAX AVE UNIT 111717",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800421975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14221 E 4TH AVE STE 2-126",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800118717",
            "telephone_number": "720-507-4779",
            "fax_number": "720-367-5067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILE HIGH PSYCHIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-13",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A",
        "authorized_official_last_name": "CHISM",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "720-507-4779"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; 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.