Basic Information
Provider Information | |||||||||
NPI: | 1578780136 | ||||||||
EntityType: | 2 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: | COLORADO ORTHOPEDIC SPECIALISTS PARKER | ||||||||
LastName: |   | ||||||||
FirstName: |   | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: | COLORADO LIMB CONSULTANTS PARKER | ||||||||
OtherOrganizationType: | 3 | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 1601 E 19TH AVE | ||||||||
Address2: | SUITE 3300 | ||||||||
City: | DENVER | ||||||||
State: | CO | ||||||||
PostalCode: | 802181216 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3038370072 | ||||||||
FaxNumber: | 3038370075 | ||||||||
Practice Location | |||||||||
Address1: | 9397 CROWN CREST BLVD | ||||||||
Address2: | SUITE 301 | ||||||||
City: | PARKER | ||||||||
State: | CO | ||||||||
PostalCode: | 801388575 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3038370072 | ||||||||
FaxNumber: | 3038370075 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 04/18/2007 | ||||||||
LastUpdateDate: | 07/21/2022 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: |   | ||||||||
AuthorizedOfficialLastName: | BURKE | ||||||||
AuthorizedOfficialFirstName: | KARA | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: | PRACTICE MANAGER | ||||||||
AuthorizedOfficialTelephone: | 3038370072 | ||||||||
IsSoleProprietor: |   | ||||||||
IsOrganizationSubpart: | N | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X |   | CO | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |   |
No ID Information.