Individual provider Active NPI

Holly S Leroux

  • Surgery Physician
  • Wheat Ridge, CO
National Provider Identifier
1841334638
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
91142 Issued in CO
Practice address
4803 Ward Rd
Wheat Ridge, CO 80033-1902
Phone
(303) 764-4731
NPI assigned
Feb 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 91142 CO Primary

Addresses

Primary practice location

4803 Ward Rd
Wheat Ridge, CO 80033-1902

Mailing address

753 W Birch CT
Louisville, CO 80027-1151
Phone (303) 442-5453

Other identifiers 1

IdentifierTypeStateIssuer
004542OtherKAISER-COMMERCIAL NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
91142COMDSurgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841334638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "753 W BIRCH CT",
            "city": "LOUISVILLE",
            "state": "CO",
            "postal_code": "800271151",
            "telephone_number": "303-442-5453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4803 WARD RD",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800331902",
            "telephone_number": "303-764-4731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEROUX",
        "first_name": "HOLLY",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CO",
            "license": "91142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER-COMMERCIAL NUMBER",
            "identifier": "004542",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheat Ridge, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.