Individual provider Active NPI

John P. Lawrence, PA-C, MMSC

  • Physician Assistant
  • Denver, CO
National Provider Identifier
1962738401
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PAL-2903 Issued in CO
Practice address
6310 E Exposition Ave
Denver, CO 80224
Phone
(720) 756-7162
NPI assigned
Oct 18, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0002903 CO
Physician Assistant 363A00000X PAL-2903 CO Primary

Addresses

Primary practice location

6310 E Exposition Ave
Denver, CO 80224

Mailing address

PO Box 2332
Gypsum, CO 81637-2332
Phone (719) 849-0784

Other practice location 1

3601 S Broadway
Englewood, CO 80113
Phone (303) 658-0059

Other identifiers 1

IdentifierTypeStateIssuer
0002903OtherCOCOLORADO PA LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20091123000173 CO Practitioner - Physician Assistant 6002955515 Reassigns benefits to 1 organization
I20221221001757 TX Practitioner - Physician Assistant 6002955515 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PAL-2903COMDPhysician Assistant
0002903COMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Medical Group Inc CurrentSince Sep 4, 2025 Accepting new patients
Mile High Treatment and Recovery Inc CurrentSince Apr 1, 2023 Accepting new patients

Locations

6310 E Exposition Ave
Denver, CO 80224
Phone (303) 320-1630

3601 S Broadway
Englewood, CO 80113
Phone (303) 658-0059

Organizations & group practices 4

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": "1255824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1962738401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2332",
            "city": "GYPSUM",
            "state": "CO",
            "postal_code": "816372332",
            "telephone_number": "719-849-0784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6310 E EXPOSITION AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80224",
            "telephone_number": "720-756-7162"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 S Broadway",
            "address_purpose": "LOCATION",
            "city": "Englewood",
            "state": "CO",
            "postal_code": "80113",
            "country_code": "US",
            "telephone_number": "303-658-0059",
            "fax_number": "303-800-9755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "JOHN",
        "middle_name": "P.",
        "name_prefix": "Mr.",
        "credential": "PA-C, MMSC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-18",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "0002903",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PAL-2903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLORADO PA LICENSE",
            "identifier": "0002903",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.