Organization Active NPI

North Metro Infectious Disease Specialists, P.C.

  • Infectious Disease Physician
  • Thornton, CO
National Provider Identifier
1851423875
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
25375 Issued in CO
Legal business name
NORTH METRO INFECTIOUS DISEASE SPECIALISTS, P.C.
Practice address
9141 Grant St
Suite 235
Thornton, CO 80229-4374
Phone
(303) 522-4686
Fax
(303) 980-0431
NPI assigned
Mar 12, 2007
Last updated
Jun 25, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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

Authorized official

Name
Mary Lou Cullinan, M.D.
Title
Physician
Phone
(303) 522-4686

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RI0200X 25375 CO Primary

Addresses

Primary practice location

9141 Grant St
Suite 235
Thornton, CO 80229-4374

Mailing address

9141 Grant St
Suite 235
Thornton, CO 80229-4374
Phone (303) 522-4686

Other identifiers 1

IdentifierTypeStateIssuer
31482775MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051018000575 CO Part B Supplier - Clinic/Group Practice 0143246306 Receives reassigned benefits from 1 practitioner
Practice locations: Thornton, CO

National Provider Directory

National Provider Directory

Locations

9141 Grant St
Ste 235
Thornton, CO 80229
Phone (303) 252-0100

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1851423875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9141 GRANT ST",
            "address_2": "SUITE 235",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802294374",
            "telephone_number": "303-522-4686",
            "fax_number": "303-980-0431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9141 GRANT ST",
            "address_2": "SUITE 235",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802294374",
            "telephone_number": "303-522-4686",
            "fax_number": "303-980-0431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH METRO INFECTIOUS DISEASE SPECIALISTS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "CULLINAN",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "LOU",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "303-522-4686",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CO",
            "license": "25375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31482775",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thornton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; 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.