Mile High Spine and Pain Center LLC

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

Legal business name

MILE HIGH SPINE AND PAIN CENTER LLC

Practice address

12061 Tejon St Ste 600
Westminster, CO 80234-2325

Phone

(303) 457-0123

Fax

(303) 252-4065

NPI assigned

Mar 11, 2025

Last updated

Mar 11, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Serena HettickNPI 1295032191

Title

Owner

Phone

(303) 457-0123

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Practitioners 6

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.

• Rachel Lee

  • Family Nurse Practitioner
  • Westminster, CO
  • NPI 1447028634
  Medicare reassignment Care Compare group NPD
• Courtney Williams

  • Family Nurse Practitioner
  • Westminster, CO
  • NPI 1124586573
  Medicare reassignment Care Compare group NPD
• Tamara R Johnson, MD

  • Family Medicine Physician
  • North Platte, NE
  • NPI 1992739890

  CO

  Medicare reassignment NPD
• Taylor Scott, FNP

  • Family Nurse Practitioner
  • Austin, TX
  • NPI 1275493256

  CO

  Medicare reassignment NPD
• Serena Nicole Hettick, D.C

  • Chiropractor
  • Scottsdale, AZ
  • NPI 1295032191
  NPD Authorized official
• Warner Martin Hettick, D.C.

  • Chiropractor
  • Westminster, CO
  • NPI 1134445984
  NPD (past)

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

{
    "created_epoch": "1741651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741651200000",
    "number": "1982403143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12061 TEJON ST STE 600",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "802342325",
            "telephone_number": "303-457-0123",
            "fax_number": "303-252-4065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12061 TEJON ST STE 600",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "802342325",
            "telephone_number": "303-457-0123",
            "fax_number": "303-252-4065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILE HIGH SPINE AND PAIN CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-11",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A",
        "authorized_official_last_name": "HETTICK",
        "authorized_official_first_name": "SERENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-457-0123"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mile High Council on Alcoholism and Drug Abuse (Mile High Behavioral Healthcare)
• Mile High Council on Alcoholism and Drug Abuse (Mile High Behavioral Healthcare)
• Mile High Council on Alcoholism and Drug Abuse (Mile High Behavioral Healthcare)
• Mile High Diabetes Vein and Wound Center LLC
• Mile High Otolaryngology
• Caroline S Miles, MD
• Milestones Developmental Center, LLC
• Shawn W Milhauser, PA-C
• Josi Millar, LMT
• Helen Miller

• Adult Medicine Physician in Westminster, CO
• Providers in Westminster, CO by specialty
• Adult Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.