Active NPI
David Oba
- Family Medicine Physician
- Las Animas, CO
National Provider Identifier
1871661264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 30326
- Practice address
- 11560 County Route FF0.75
Las Animas, CO 81054-0000 - Phone
- (719) 456-2610
- Fax
- (719) 456-2028
- NPI assigned
- Dec 1, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 30326 | CO | Primary |
Addresses
Primary practice location
11560 County Route FF0.75
Las Animas, CO 81054-0000
Mailing address
615 S. Hahns Peak Avenue
Pueblo West, CO 81007-2898
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30326 | CO | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Total Life Care, LLC | Family Medicine | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Colorado City, CO
- NPI 1679516348
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1871661264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 S. HAHNS PEAK AVENUE",
"city": "PUEBLO WEST",
"state": "CO",
"postal_code": "810072898"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11560 COUNTY ROUTE FF0.75",
"city": "LAS ANIMAS",
"state": "CO",
"postal_code": "810540000",
"telephone_number": "719-456-2610",
"fax_number": "719-456-2028"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OBA",
"first_name": "DAVID",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CO",
"license": "30326",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Animas, 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.