NPIMap

Organization Active NPI

Platte Valley Medical Group, LLC

Doing business as Intermountain Health Platte Valley Hospital - Wound Care Center

  • Family Medicine Physician
  • Brighton, CO
National Provider Identifier
1922812593
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PLATTE VALLEY MEDICAL GROUP, LLC
Doing business as
Intermountain Health Platte Valley Hospital - Wound Care Center
Practice address
1606 Prairie Center Pkwy Ste 140
Brighton, CO 80601-4004
Phone
(303) 498-3030
Fax
(303) 498-3029
NPI assigned
Feb 4, 2025
Last updated
Feb 4, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
BRIGHTON COMMUNITY HOSPITAL ASSOCIATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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

Authorized official

Name
Jon McDaniel
Title
VP Finance
Phone
(303) 272-0231

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Wound Care Registered Nurse 163WW0000X NU
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

1606 Prairie Center Pkwy Ste 140
Brighton, CO 80601-4004

Mailing address

500 Eldorado Blvd Ste 4300
Broomfield, CO 80021-3564
Phone (303) 272-0566

Other names 1

  • Intermountain Health Platte Valley Hospital - Wound Care Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180112000840 CO Part B Supplier - Clinic/Group Practice 5890054100 Receives reassigned benefits from 201 practitioners
19 other NPIs on this enrollment
Practice locations: Brighton, CO; Thornton, CO; Fort Lupton, CO; Denver, CO; Commerce City, CO

Other NPIs on the same Medicare enrollment 19

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 19

National Provider Directory

National Provider Directory
Tax ID family
Platte Valley Medical Group LLC15 organizations share this tax ID, including this one
Part of
Brighton Comm Hosp Assn

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations

217 N 50th Ave
Brighton, CO 80601

10569 Chambers Rd
Unit 102
Commerce City, CO 80022
Phone (303) 227-6721

4859 Yampa St
Denver, CO 80249
Phone (303) 498-1885

1450 Dexter St
Ste 101
Fort Lupton, CO 80621
Phone (303) 857-2087

1450 Dexter St
Ste 102
Fort Lupton, CO 80621
Phone (303) 857-7873

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 202

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.

View all 202

NPI Registry JSON

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

{
    "created_epoch": "1738627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738627200000",
    "number": "1922812593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 ELDORADO BLVD STE 4300",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800213564",
            "telephone_number": "303-272-0566",
            "fax_number": "303-272-0390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1606 PRAIRIE CENTER PKWY STE 140",
            "city": "BRIGHTON",
            "state": "CO",
            "postal_code": "806014004",
            "telephone_number": "303-498-3030",
            "fax_number": "303-498-3029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLATTE VALLEY MEDICAL GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BRIGHTON COMMUNITY HOSPITAL ASSOCIATION",
        "enumeration_date": "2025-02-04",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A",
        "authorized_official_last_name": "MCDANIEL",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "303-272-0231"
    },
    "taxonomies": [
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Intermountain Health Platte Valley Hospital - Wound Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brighton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; 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.