NPIMap

Organization Active NPI

Premise Health of Colorado Medical, P.C.

Doing business as The Wellness Center operated by Premise Health Deer Creek

  • Clinic/Center
  • Littleton, CO
National Provider Identifier
1770120677
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
PREMISE HEALTH OF COLORADO MEDICAL, P.C.
Doing business as
The Wellness Center operated by Premise Health Deer Creek
Practice address
12999 W Deer Creek Canyon Rd
Littleton, CO 80127-5146
Phone
(720) 842-6997
Fax
(720) 842-6996
NPI assigned
Dec 10, 2019
Last updated
Aug 23, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

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

Authorized official

Name
Dr. Jon Leizman, MD
Title
President
Phone
(216) 479-9063

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

12999 W Deer Creek Canyon Rd
Littleton, CO 80127-5146

Mailing address

5500 Maryland Way
Brentwood, TN 37027-7048
Phone (844) 407-7557

Other names 1

  • The Wellness Center operated by Premise Health Deer Creek Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D2177091Premise Health of Colorado Medical PC12999 W Deer Creek Canyon Rd, Room Rb548, Littleton, CO 80127Certificate of waiverJan 2, 2028

National Provider Directory

National Provider Directory
Tax ID family
Premise Health of Colorado Medical PC20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

Organizations that report the same tax identification number in the National Provider Directory.

View all 19

Locations

12999 W Deer Creek Canyon Rd
Littleton, CO 80127
Phone (303) 932-5155

NPI Registry JSON

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

{
    "created_epoch": "1575936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661212800000",
    "number": "1770120677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MARYLAND WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277048",
            "telephone_number": "844-407-7557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12999 W DEER CREEK CANYON RD",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801275146",
            "telephone_number": "720-842-6997",
            "fax_number": "720-842-6996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMISE HEALTH OF COLORADO MEDICAL, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-10",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A",
        "authorized_official_last_name": "LEIZMAN",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "216-479-9063",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Wellness Center operated by Premise Health Deer Creek",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Littleton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.