Individual provider Active NPI

Johnny Shen, M.D.

  • Family Medicine Physician
  • Denver, CO
National Provider Identifier
1881988541
Registry record updated Nov 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR0054115 Issued in CO
Practice address
760 S Colorado Blvd
Suite a
Denver, CO 80246-1954
Phone
(303) 692-8000
NPI assigned
May 30, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X BP10040640 TX
Family Medicine Physician 207Q00000X DR0054115 CO Primary

Addresses

Primary practice location

760 S Colorado Blvd
Suite a
Denver, CO 80246-1954

Mailing address

2003 Birnam Glen Dr
Sugar Land, TX 77479-6421
Phone (267) 231-9016

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
I20150319000785 CO Practitioner - Family Practice 7012135049 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical School at San Antonio, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Care Solutions PCGroup PAC ID 4183847114, 24 clinicians

Practice addresses (Care Compare)

760 S Colorado Blvd
Unit a
Denver, CO 80246-1900
Phone (303) 692-8000

760 S Colorado Blvd
Unit B
Denver, CO 80246-1956
Phone (303) 692-8000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR0054115COMDFamily Medicine Physician
BP10040640TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Care Solutions Glendale, P.C. Family Medicine CurrentSince Apr 16, 2015 Accepting new patients
Statlab Diagnostics, LLC Family Medicine Current Accepting new patients

Locations

1295 N Colorado Blvd
Denver, CO 80206
Phone (303) 399-6120

777 E Speer Blvd
Ste 100
Denver, CO 80203
Phone (303) 733-4000

3800 Irving St
Ste 10
Denver, CO 80211
Phone (303) 477-6000

760 S Colorado Blvd
Unit A
Glendale, CO 80246
Phone (303) 692-8000

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1306713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448409600000",
    "number": "1881988541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2003 BIRNAM GLEN DR",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774796421",
            "telephone_number": "267-231-9016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 S COLORADO BLVD",
            "address_2": "SUITE A",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802461954",
            "telephone_number": "303-692-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEN",
        "first_name": "JOHNNY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-30",
        "last_updated": "2015-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "BP10040640",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR0054115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.