Basic Information
Provider Information | |||||||||
NPI: | 1033146774 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | HELLER | ||||||||
FirstName: | ARTHUR | ||||||||
MiddleName: | P | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 4900 S MONACO ST | ||||||||
Address2: | #210 | ||||||||
City: | DENVER | ||||||||
State: | CO | ||||||||
PostalCode: | 802373486 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3037892663 | ||||||||
FaxNumber: | 3037884871 | ||||||||
Practice Location | |||||||||
Address1: | 799 E HAMPDEN AVE | ||||||||
Address2: | SUITE 400 | ||||||||
City: | ENGLEWOOD | ||||||||
State: | CO | ||||||||
PostalCode: | 801132700 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3037892663 | ||||||||
FaxNumber: | 3037884871 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 06/27/2006 | ||||||||
LastUpdateDate: | 04/03/2013 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X |   |   | N |   | Other Service Providers | Specialist |   | 207X00000X | 15654 | CO | Y |   | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |   |
ID Information
ID | Type | State | Issuer | Description | 1245556091 | 05 | NE |   | MEDICAID | 01156546 | 05 | CO |   | MEDICAID | 129802000 | 05 | WY |   | MEDICAID | 100278120B | 05 | KS |   | MEDICAID |