Individual provider Active NPI

Carson Elizabeth Petty Maynard, DO

  • Rheumatology Physician
  • Wheat Ridge, CO
National Provider Identifier
1770929754
Registry record updated Apr 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
60242 Issued in CO
Practice address
3455 Lutheran Pkwy Ste 100
Wheat Ridge, CO 80033-6028
Phone
(720) 494-4700
Fax
(720) 494-4706
NPI assigned
May 16, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 60242 CO Primary
Internal Medicine Physician 207R00000X 60242 CO

Addresses

Primary practice location

3455 Lutheran Pkwy Ste 100
Wheat Ridge, CO 80033-6028

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 579-3203

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180906003082 CO Practitioner - Rheumatology 0446555221 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Philadelphia College of Osteopathic Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optumcare Colorado Medical Group LLCGroup PAC ID 2769706431, 187 clinicians

Practice addresses (Care Compare)

Colorado Springs, CO 80903
Phone (719) 538-2900

1625 Medical Ctr PT
Suite 290
Colorado Springs, CO 80907-8722
Phone (719) 635-5148

Hospital & facility affiliations

  • Good Samaritan Medical Center LLC Hospital, Lafayette, CO, CCN 060116

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
60242COMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optumcare Colorado Medical Group LLC CurrentSince Mar 1, 2024 Accepting new patients
New West Physicians Inc Internal Medicine CurrentSince May 22, 2023 Accepting new patients
Optumcare Colorado Medical Group LLC Rheumatology CurrentSince Mar 1, 2024 Accepting new patients
New West Physicians Inc CurrentSince May 22, 2023 Accepting new patients
Optumcare Colorado Medical Group LLC Current Accepting new patients
Optumcare Colorado Medical Group LLC Past Accepting new patients

Locations

1625 Medical Center Pt
Ste 290
Colorado Springs, CO 80907
Phone (719) 635-5148

1707 Cole Blvd
Ste 100
Lakewood, CO 80401
Phone (303) 716-8013

1715 Iron Horse Dr
Ste 100
Longmont, CO 80501
Phone (720) 215-3572

11990 Grant St
Ste 108
Northglenn, CO 80233
Phone (720) 494-7000

3455 Lutheran Pkwy
Ste 100
Wheat Ridge, CO 80033
Phone (303) 318-2900

Interoperability endpoints

  • Direct secure messaging: cmaynard119229@westdirect.optum.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1368662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776124800000",
    "number": "1770929754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-579-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3455 LUTHERAN PKWY STE 100",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800336028",
            "telephone_number": "720-494-4700",
            "fax_number": "720-494-4706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYNARD",
        "first_name": "CARSON",
        "middle_name": "ELIZABETH PETTY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-16",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "CO",
            "license": "60242",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "60242",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheat Ridge, CO

Sources for this page

Verify at the official NPI Registry.