Basic Information
| Provider Information | |||||||||
| NPI: | 1639447154 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NOVAMED SURGERY CENTER OF DENVER LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | CHERRY HILLS SURGERY CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3535 S LAFAYETTE ST STE 200 | ||||||||
| Address2: | |||||||||
| City: | ENGLEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801133954 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8666317890 | ||||||||
| FaxNumber: | 8472272750 | ||||||||
| Practice Location | |||||||||
| Address1: | 3535 S LAFAYETTE ST STE 200 | ||||||||
| Address2: | |||||||||
| City: | ENGLEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801133954 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8666317890 | ||||||||
| FaxNumber: | 3032820266 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/12/2011 | ||||||||
| LastUpdateDate: | 04/17/2020 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | BALDOCK | ||||||||
| AuthorizedOfficialFirstName: | JENNIFER | ||||||||
| AuthorizedOfficialMiddleName: | BOYD | ||||||||
| AuthorizedOfficialTitleorPosition: | OFFICER AND AUTHORIZED OFFICIAL | ||||||||
| AuthorizedOfficialTelephone: | 6152345900 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 04/17/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.