Medical RTD Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

45108 Issued in CO

Legal business name

MEDICAL RTD INC

Practice address

7615 W 38TH Ave
Unit B-123
Wheat Ridge, CO 80033-6172

Phone

(303) 432-2776

Fax

(303) 432-2216

NPI assigned

Mar 13, 2007

Organization subpart

No

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

Authorized official

Name

Tatyana I Datkhaeva, MDNPI 1609909423

Title

Owner Physician

Phone

(720) 540-7155

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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.

• Tatyana I Datkhaeva, MD

  • Family Medicine Physician
  • Denver, CO
  • NPI 1609909423
  NPD (past) Authorized official

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1912030743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7615 W 38TH AVE",
            "address_2": "UNIT B-123",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "80033",
            "telephone_number": "720-540-7155",
            "fax_number": "720-540-7155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7615 W 38TH AVE",
            "address_2": "UNIT B-123",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800336172",
            "telephone_number": "303-432-2776",
            "fax_number": "303-432-2216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL RTD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "DATKHAEVA",
        "authorized_official_first_name": "TATYANA",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "OWNER PHYSICIAN",
        "authorized_official_telephone_number": "720-540-7155",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "45108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "45108",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "82709513",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samantha Jane McNutt
• Michelle (Shelley) McRae
• Karen E McWay
• Carol Meadors, M.A.
• Raymond Meadors, PH.D.
• Lisa L Medina, NP
• Rachel Corinne Meeks-Johnson
• Meghan Rose Acupuncture LLC
• Promilla Mehra, MD
• Payal Shailesh Mehta, PT

• Family Medicine Physician in Wheat Ridge, CO
• Providers in Wheat Ridge, CO by specialty
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.